1-3-β-D葡聚糖检测的影响因素及其在真菌感染中的诊断价值探讨

目的：探讨1-3-β-D葡聚糖检测(G实验)在诊断真菌感染性疾病上的临床意义及影响因素。方法：应用MB-80微生物动态快速检测系统及GKT150动态真菌检测试剂盒定量检测血浆中1-3-β-D葡聚糖的含量。结果：总1066例标本，阳性395例，占37.05%，阴性671例，占62.95%。结论：G实验是一种实用的真菌感染早期诊断方法，对临床上难以诊断的疾病也能起到一个良好的筛查作用，同时也能对真菌感染的患者的治疗效果起到一个动态观察的作用。造成G实验假阳性的主要原因可能为：标本溶血或乳糜血，医疗纱布或某些医疗物品中含有葡聚糖成分(如白蛋白、凝血因子、免疫球蛋白等)，某些细菌败血病患者(尤其是链球菌败血症)，含酶抑制剂的抗菌药物等。Objective: To discuss (1,3)-β-D-glucan detection (G experimental) clinical significance in the diag- nosis of fungal infections and its influence factors. Methods: Rapid microbial detection system and GKT150 fungal detection kit were used to test the plasma levels of (1,3)-β-D-glucan. Results: A total of 1066 cases were collected, of which 395 cases were positive(37.05%), and 671 cases were negetive (62. 95%). Conclusion: G experiment is a kind of method in the early diagnosis of fungal infection, and also can have a good screening effect for disease which is difficult to diagnose. G experiment could be used for early diagnose of the invasive fungal infection. Reasons for the false positive test minght include: Hemolysis or chylemia, medical gauze or some medical items contianing glucan ingredient, some patients with bacterial sepsis and inhibitors with antibacterial drugs.