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find Keyword "侵袭性曲霉菌" 2 results
  • 联合检测半乳甘露聚糖和(1→3)-β-D葡聚糖在诊治侵袭性曲霉菌感染中的研究进展

    近年随着广谱抗生素和免疫抑制剂的使用,侵袭性真菌感染(invasive fungal disease,IFD)的发病率逐年上升。其中侵袭性曲霉病(invasive aspergillosis,IA)在IFD中比例逐年增高。侵袭性曲霉菌感染在血液科和重症加强治疗病房(ICU)最为常见,其次为呼吸内科、感染科和免疫科,IA为免疫功能低下患者致死率高的主要原因,造血干细胞移植(HSCT)患者中IA的发病率为2%~26%,在血液病和造血干细胞移植患者中IA死亡率高达70.0%~90.0%。造成死亡率高的主要原因是在病程早期不能对IA进行可靠诊断,往往使患者延误治疗而死亡。因此,选择正确、合适的早期诊断方法对疾病的预后具有决定性意义。传统的诊断方法如影像学、真菌直接镜检、培养及组织病理学检查的敏感性不高,检出率低,难以用于早期诊断。因此,新的诊断方法对IA的治疗至关重要。血清学诊断方法是应用免疫和生化方法检测血清或其他体液中的真菌细胞壁和胞质成分,分为抗原和抗体检查两类。但由于IFD多继发于严重免疫受损患者,往往缺乏可检测到的抗体,或者抗体的产生变化较大,因此以检测真菌抗原为主。目前半乳甘露聚糖(GM)和(1→3)-β-D葡聚糖(BG)成为真菌检查中非常重要的两个抗原。

    Release date:2016-08-30 11:58 Export PDF Favorites Scan
  • Detection of Invasive Aspergillosis by Serum Galactomannan Test: A Systematic Review

    Objective To assess the quality of current domestic literature about enzyme-linked immunosorbent assay (ELISA) for invasive aspergillosis diagnosis by detecting Aspergillus galactomannan (GM) antigen, and to analyze the sources of bias and variability, as well as the diagnostic ability of different thresholds. Methods Both computer-based online search and manual retrieval were employed to identify relevant articles. The statistical information and quality of science were assessed and classified. The data were analyzed using Meta Disc 1.4 software. The best cutoff value for defining a positive test result was selected by summarizing the following statistical indicators as sensitivity, specificity, likelihood ratio (LR) and summary receiver operating characteristic curve (SROC curve), and by calculating the area under the curve (AUC) as well. Results A total of 20 studies among 2658 literatures were included in accordance with the inclusion criteria, and were divided into different groups based on different cutoff values. Though heterogeneity tests showed no threshold effect, and there were other reasons of heterogeneity. So the data were analyzed by random effects model. The results showed that, compared with other groups, the one with cutoff value set at 0.7 (AUC=0.9456, Q= 0.884 6) showed the best accuracy in diagnosing. Conclusion ELISA detection of Aspergillus GM antigen with cutoff value set at 0.7 has important significance in the early diagnosis of invasive aspergillosis, and it can be conducive to reduce mortality in patients at high risk for Aspergillus infection.

    Release date:2016-09-07 11:07 Export PDF Favorites Scan
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