The Value Of Galactomannan Antigen And1,3-β-D-glucan For Detection Of Invasive Aspergillosis In The Intensive Care Unit

Objective：To evaluate the value of bronchoalveolar lavage fluid andserum galactomannan (GM) detection,1,3-β-D-glucan (BG) detection forearly diagnosis of invasive aspergillosis (IA) in the intensive care unit(ICU) patients.Methods：The patients in the intensive care unit highly suspected ofhaving IA were enrolled.Detection of patients with bronchoalveolarlavage fluid and serum samples of GM antigen and BG antigen level, andalso the pathology, microbiology and tissue culture, such as chestradiographic inspection.According to the diagnostic criteria were dividedinto IA case group and control group.Statistical analysis of differentboundary values (0.5,1.0and1.5) when GM test efficiency to thediagnosis of IA, find out the appropriate GM test boundaryvalues.Efficiency of diagnosiswas counted in G test.Compared with otherdiagnosis, evaluation of GM and G trials had in early clinical diagnosisvalue of IA.Evaluation of GM experiment and G experiment before andafter the change in the meaning of antifungal therapy.Results：Among94enrolled patients in this study,19cases were diagnosed with IA (1proven,10probable and8possible),the remained75patients were as control group.Serum and BALF of GM found cases ofgroup was obviously higher than that of control group（1.51±0.57vs.0.43±0.18、1.09±0.51vs.0.40±0.21）.When GM boundaryvalue is1.0, BALF GM detection sensitivity, specific degree, positivepredictive value, negative prediction is84.2%,96.0%,84.2%,96.0%, thediagnostic efficiency is higher.The two consecutive serum GMdetect(cutoff=0.5) specificity94.7%, higher than the single boundaryvalue is better.In theG test,BGof serum and BALF in case group wereobviously higher than that of control group.In BALF BG detectionsensitivity, specific and positive predictive value, negative prediction is78.9%、86.6%、60.0%、94.2%.Compared with other diagnosis methods,GM and G detection diagnosis efficiency is high, the time is short. WhenGM boundary value0.5, joint G test can improve the specificdegrees.GMtest(cutoff=0.5) joint G test can improve the specificdegrees.GM and G values have obvious change in before and aftertreatment, prompt meaningful.Conclusion：Bronchoalveolar lavage fluid and serum GM anddetection for early clinical diagnosis and treatment of invasive aspergillushas important significance, the joint detection can apply to more seriouspatients, improve the efficiency of detection, is a kind of safe andeffective auxiliary examination method Detection of BALF and serumGM is a valuable adjunctive diagnostic tool for diagnosis of IA.