The Value Of Serum Immunological Test For Early Diagnosis Of Invasive Pulmonary Aspergillosis

Object:Invasive pulmonary aspergillosis(IPA)refers to an infectious disease caused by the invasion of an aspergillus mycelium into the lung parenchyma,mainly in people with blood system diseases and basic diseases of the lungs.Clinical data show that most patients with invasive aspergillosis have less than 14 days from diagnosis to death.Therefore,it is of great clinical significance to explore early,high-efficiency,non-invasive IPA diagnostic methods.This study explores single antigen(1,3)-?-The value of D-dextran(G test)and galactomannan(GM)(GM test),Aspergillus fumigatus IgG antibody detection and combined detection in the early diagnosis of IPA patients.Method: Twenty-six patients with invasive pulmonary aspergillosis(IPA)who were clinically diagnosed in the Affiliated Hospital of China Medical University and the Affiliated Central Hospital of Shenyang Medical College from November 2016 to September 1818,and 52 patients with clinically diagnosed non-IPA were randomly selected as control group.26 patients with IPA included 20 males and 6 females.The basic diseases were 7 blood diseases,6 basic lung diseases,4 lung malignant diseases,2other tumors,3 cardiovascular diseases,and 1 case.The average age of patients with diabetes and 3 other diseases was 57.54±15.55;52 patients with non-IPA included 37 males and 15 females.The basic diseases were 14 cases of blood diseases,12 cases of pulmonary basic diseases,and 7 cases of pulmonary malignancy.The disease,5 other tumors,7 cardiovascular diseases,2 diabetes,and 5 other diseases,the mean age was62.56±14.57.The 78 patients were retrospectively analyzed.The serum G test,GM test,and Aspergillus fumigatus IgG antibody levels were measured in the study subjects.The early diagnostic value of each test item and joint test in IPA patients was investigated.Result: In the single test,the positive rate of GM test and Aspergillus fumigatus IgG antibody in IPA patients was 46.15% and 65.38%,and the positive rate of non-IPA patients was 11.54% and 23.08%.The difference was statistically significant.The positive rate of G test in IPA patients was 38.46.Although the positive rate was 30.77%higher than that of non-IPA patients,the difference was not statistically significant.The positive rate of G+IgG,GM+IgG,G+GM+IgG in serially detected IPA patients was28.08%,38.46% and 11.54%.The positive rates of high and non-IPA patients were3.85%,1.92%,and 0.00%,and the difference was statistically significant.The positive rate of G+GM test in IPA patients was 11.54% higher than that of non-IPA patients,1.92%,but the difference was not statistical.Learning meaning.The positive rates of G/GM,G/IgG,GM/IgG,G/GM/IgG in IPA patients with parallel test were 73.08%,80.77%,76.92% and 88.46%,and the positive rates of patients with non-IPA were36.46% and 48.08%.28.85% and 58.85%;the difference was statistically significant.The GM test has higher specificity(88.46%)and PPV(66.67%).Aspergillus fumigatus IgG antibody detection has higher sensitivity(65.38%)and NPV(81.63%);the three series can be used for diagnostic specificity and PPV.Increase to 100%,100%;three parallel connections can increase their sensitivity and NPV to 88.46%,88.89%.Conclusion: First,The early diagnosis o patients with IPA can be selected and GM test Aspergillus fumigatus IgG antibodies detected by the detector;Second,series early detection can help diagnose a patient IPA;Third,early detection can be used in parallel screening of patients with IPA.