Diagnostic Value Of Serum Galactomannan Detection In Invasive Pulmonary Aspergillosis

Object:Invasive pulmonary aspergillosis(IPA) occurs mainly in immunocompromised people. Clinical data show that the time from diagnosis to death of patients with invasive aspergillosis is less than 14 days.therefore, early and rapid diagnosis of invasive aspergillosis is very important. Plasma galactomannan(GM) is a component of aspergillus cytoderm, which is a kind antigen released in body when people are infected. This article is to evaluate the value of galactomannan(GM) detection for early diagnosis of IPA in patients. Method:Blood samples were obtained from 46 patients in the China-Japan Union Hospital of Jilin University and the second hospital of Jilin university from 2014.01 to 2015.10. Among these samples, 21 cases were neoplastic hematologic disorder patients,13 case were pneumology department respiratory medicine patients,4 cases were nephrology department patients,8 cases were Digestive Department.male:20,female :26.The agde of these patients were from 41 to 82 years old, and the median age was 47 years old.GM antigenand and plasma1,3-β-Dglucan antigen level were detect with the serum and Plasma samples of the patents,and criteria were divided according to the diagnosis.Then we recorded and analysised the pathology,microbiology and tissue culture of patients.Sensitivity,specificity and predictive values were calculated respectively and compared. Result:Among 46 suspected cases,1 patients were finally diagnosed with IPA,and 5 patients were probable diagnosis.There were 5 cases in IAP group were GM test positive. Copared with Non-IPA patient group,the difference of GM test levels in patients with IPA was statistically significant.Sensitivity was 83.3%,specificity was 97.5%,positive predictive value was 83.3%,negative predictive value was 97.5%,the matching rate was 95.7.8%,Youden index was 0.808.The positive results of GM test changed early than CT.For proven diagnosed patients,GM test positive ahead CT changes 5 day.While in probable patients,GM test positive advance CT changes(4.3±2.9)d daverage.Patients received antifungal treatment needed to receive dynamic monitoring of GM trials,for GM level positively correlating with the therapeutic effect.Combind G test and GM test,the level of sensitivity increased. Conclusion:First,GM test can easily and quickly detect invasive pulmonary aspergillosis,which has high sensitivity, specificity and coincidence in clinical diagnosis. Second, compared with the traditional methods(such as lung CT, pathologic examination, microbiological culture), GM trials was easier and faster for the early diagnosis,which played an important role in the early diagnosis. Third,dynamic monitoring of GM trials was valuable for clinical treatment and prognosis of patients with IPA. Fourth, GM Test combined with fungus G testing for diagnosing IPA can greatly improve the sensitivity and specificity of the diagnosis of IPA, which was of significance to guide the diagnosis and treatment of early IPA.