Study on the diagnostic value of combined detection of galactomannan in bronchoalveolar lavage fluid and IgG in blood for pulmonary aspergillosis
10.3760/cma.j.cn115455-20191230-01104
- VernacularTitle:肺泡灌洗液半乳甘露聚糖、血液烟曲霉IgG联合检测对肺曲霉病的诊断价值研究
- Author:
Fengfeng FU
1
;
Xiaoyong DU
;
Zuxi YAN
Author Information
1. 浙江省海盐县人民医院呼吸内科 314300
- From:
Chinese Journal of Postgraduates of Medicine
2020;43(6):513-516
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the diagnostic value of the combined detection of galactomannan (Gm) in bronchoalveolar lavage fluid (BALF) and IgG of aspergillus fumigatus in blood for pulmonary aspergillosis.Methods:Seventy-four patients with pulmonary aspergillosis admitted to Haiyan People′s Hospital from February 2017 to September 2019 were divided into chronic pulmonary aspergillosis group (35 cases) and invasive pulmonary aspergillosis group (39 cases). The BALF of ttwo groups were collected, the Gm level of BALF was tested, and the IgG level of blood aspergillus fumigatus was detected by using the aspergillus IgG enzyme-linked immunosorbent assay (ELISA) kit, and the positive prediction rate, negative prediction rate, diagnostic sensitivity, specificity and accuracy of the two methods was compared.Results:The Gm I value of BALF and the IgG level of blood in invasive pulmonary aspergillosis group were lower than those in chronic pulmonary aspergillosis group: 0.65 ± 0.09 vs. 0.98 ± 0.12, (118.95 ± 12.31) kAU/L vs. (147.63 ± 15.32) kAU/L, and there were significant differences ( P<0.05). The positive predictive rate and negative predictive rate in combined detection of detection of GMI and IgG in BALF and blood were significantly higher than those in the single detection of GMI and IgG in BLAF and blood: 92.50%(37/40) vs. 61.90%(26/42) and 61.54%(24/39), 88.24%(30/34) vs. 53.13%(17/32) and 51.43%(18/35), and there were significant differences ( P<0.05). There was a certain correlation between the severity of pulmonary aspergillosis and the Gm I value of BALF and the IgG level of blood aspergillus fumigatus. The sensitivity and accuracy of the diagnosis in combined detection of Gm I and IgG in BALF and blood were higher than those in the single detection of Gm I and IgG in BALF and blood: 92.86%(39/42) vs. 65.00%(26/40) and 67.57%(25/37), 83.78%(62/74) vs. 75.68%(56/74) and 75.68%(56/74), the diagnostic specificity was lower than that of the single detection of GM I and IgG in BALF and blood: 71.88%(23/32) vs. 88.24%(30/34) and 83.78%(31/37), and there were significant differences ( P<0.05). Conclusions:There is a certain correlation between Gm in BALF and aspergillus fumigatus IgG in blood and the symptoms of pulmonary aspergillosis. The combined detection of Gm in BALF and aspergillus fumigatus IgG in blood is of great significance for the clinical diagnosis and treatment of pulmonary aspergillosis.
