实用医学杂志 ›› 2021, Vol. 37 ›› Issue (1): 96-100.doi: 10.3969/j.issn.1006⁃5725.2021.01.020

• 医学检查与临床诊断 • 上一篇    下一篇

炎性指标联合(1,3)诊断真菌与细菌血流感染中的价值 ⁃β⁃D 葡聚糖检测在早期鉴别

苗强,徐晓华,魏彬,白杨娟,张君龙,蔡蓓,牛倩   

  1. 1 四川大学华西医院实验医学科(成都 610041);2 成都市郫都区中医医院检验科(成都 611730)

  • 出版日期:2021-01-10 发布日期:2021-01-10
  • 通讯作者: 牛倩 E⁃mail:niuqian991@126.com
  • 基金资助:
    四川省科技厅重点研发项目(编号:2019YFS0287)

The value of inflammatory indicators combined with(1,3)⁃β⁃D glucan in the early differential diagnosis of fungal and bacterial bloodstream infections

MIAO Qiang,XU Xiaohua,WEI Bin,BAI Yangjuan,ZHANG Junlong,CAI Bei,NIU Qian
  

  1. Department of Medical Laboratory,the West China Hospital,Sichuan Univer⁃sity,Chengdu 610041,China
  • Online:2021-01-10 Published:2021-01-10
  • Contact: NIU Qian E⁃mail:niuqian991@126.com

摘要:

目的 探讨降钙素原(PCT)、C 反应蛋白(CRP)、白细胞介素 6(IL⁃6)联合(1,3)⁃β⁃D 葡聚糖 [(1,3)β⁃D⁃glucan,BDG]和半乳甘露聚糖(galactomannan,GM)检测在血流感染类型早期鉴别诊断中的临 床应用价值。方法 回顾性纳入我院2019年1-12月血培养阳性的住院患者124例。比较细菌与真菌感染 患者PCT、CRP、IL⁃6、BDG和GM试验各指标的水平,并采用受试者工作曲线(ROC)评价各指标单独及联合 检测对真菌血流感染诊断的价值。结果 真菌组 PCT、CRP IL⁃6 的水平明显低于细菌组(P < 0.05),而 BDG 的水平明显高于细菌组(P < 0.05)。PCT、CRP、IL⁃6 BDG 单独诊断真菌血流感染的 ROC 曲线下面 积(AUC)分别为 0.859、0.718、0.800 0.843(P < 0.05)。四项指标联合诊断的 AUC 0.914,与单独 CRP IL⁃6、BDG AUC 比较,差异有统计学意义(P < 0.05),与单独 PCT AUC 比较差异无统计学意义(P > 0.05)。结论 PCT、CRP、IL⁃6、BDG 水平可作为鉴别真菌与细菌血流感染的参考指标,且 PCT BDG 的鉴

关键词:

Abstract:

Objective To investigate the clinical value of procalcitonin (PCT),C ⁃ reactive protein (CRP),interleukin⁃6(IL⁃6)combined with(1,3)⁃D⁃glucan(BDG)and galactomanannan(GM)in early differ⁃ ential diagnosis of bloodstream infections. Methods We retrospectively involved 124 hospitalized patients with positive blood cultures from January to December 2019. The levels of PCT,CRP,IL⁃6,BDG and GM test indexes were compared between bacteria group and fungus group,and the receiver operating curve(ROC)was used to evaluate the diagnostic value of each index and the combined detection in fungal bloodstream infections. Results The level of PCT,CRP and IL⁃6 in the fungus group was significantly lower than those in the bacteria group(P < 0.05);while that of BDG in the fungus group was significantly higher than that in the bacterial group(P < 0.05). The area under the ROC curve(AUC)of PCT,CRP,IL⁃6,and BDG alone for the diagnosis of fungal bloodstream infections was 0.859,0.718,0.8 and 0.843 respectively(P < 0.05)but that of the combined diagnosis of the four indicators was 0.914. The comparison of AUC of CRP,IL⁃6,and BDG and that of the diagnosis value of the com⁃ bined indicated statistical significance(P < 0.05). Conclusion The level of PCT,CRP,IL⁃6 and BDG can be used as reference indicator to distinguish fungal and bacterial bloodstream infections,and the differential diagnosis value of PCT and BDG is higher. The combined detection of four indicators has certain clinical value in the early 

Key words: