山东大学耳鼻喉眼学报 ›› 2016, Vol. 30 ›› Issue (4): 94-97.doi: 10.6040/j.issn.1673-3770.0.2015.526

• 论著 • 上一篇    下一篇

血浆1-3-β-D葡聚糖对真菌性鼻窦炎的诊断价值

余鹏举1, 许风雷2, 杨军1, 陈伟3, 江满杰3   

  1. 1. 江苏省昆山市中医医院耳鼻咽喉科, 江苏 昆山 215300;
    2. 山东大学第二医院耳鼻咽喉头颈外科, 山东 济南 250000;
    3. 南京军区南京总医院耳鼻咽喉-头颈外科, 江苏 南京 210002
  • 收稿日期:2015-12-11 出版日期:2016-08-16 发布日期:2016-08-16
  • 作者简介:余鹏举. E-mail:ypj1025@163.com

Diagnostic value of plasma 1-3-β-D glucan for fungal rhinosinusitis.

YU Pengju1, XU Fenglei2, YANG Jun1, CHEN Wei3, JIANG Manjie   

  1. 1. Department of otorhinolaryngology, Traditional Chinese Medicine Hospital of Kunshan, Kunshan 215300, Jiangsu, China;2. ENT &HN Surgery Department, The Second Hospital of Shandong University, Jinan 250000, Shandong, China;3. Department of Otolaryngology-Head Neck Surgery, Nanjing General Hospital of Nanjing Military Command, PLA, Nanjing 210002, Jiangsu, China
  • Received:2015-12-11 Online:2016-08-16 Published:2016-08-16

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摘要： 目的 明确血浆1-3-β-D葡聚糖对真菌性鼻窦炎的诊断价值。 方法 选择2014年1月至2015年12月接受鼻窦炎手术的患者,依据术后病理诊断分为观察组(真菌性鼻窦炎)及对照组(细菌性鼻窦炎)。比较手术前后外周血1-3-β-D葡聚糖、C-反应蛋白(CRP)及降钙素原(PCT)的改变。 结果 共纳入符合研究条件的患者83例,其中观察组41例,对照组42例。观察组术前血浆1-3-β-D葡聚糖水平显著高于对照组(P<0.05),术后1-3-β-D葡聚糖水平显著降低(P<0.05)。相关性分析显示,观察组术前血浆1-3-β-D葡聚糖水平与PCT(t=0.701, P=0.002)及CRP(t=0.846, P=0.002)均呈现显著正相关。ROC曲线分析显示,当1-3-β-D葡聚糖取值为12.0 pg/mL时对感染的诊断敏感性为90.48%,特异性为95.12%,优于PCT及CPR。 结论 1-3-β-D葡聚糖对真菌性鼻窦炎的诊断较为可靠,有望成为辅助术前诊断的实用指标。

关键词: C-反应蛋白, 1-3-β-D葡聚糖, 真菌性鼻窦炎, 诊断, 降钙素原

Abstract: Objective To analyze the value of plasma 1-3-β-D glucan for diagnosis of fungal rhinosinusitis. Methods Patients with nasosinusitis underwent surgery treatment at our hospital from 2014 to 2015 were selected and divided into observation group(fungal rhinosinusitis)and control group(bacterial rhinosinusitis)according to the postoperative pathological diagnosis. Changes of 1-3-β-D glucan, C-reactive protein(CRP)and procalcitonin(PCT)in peripheral blood were compared. Results A total of 83 patients were enrolled, in which 41 cases were divided in observation group and 42 cases were divided in control group. Patients in observation group had a higher level of 1-3-β-D glucan than that of control group before surgery(P<0.05), but decreased significantly after surgery(P<0.05). Correlation analysis showed that, for patients in observation group, the levels of 1-3-β-D glucan had significant positive correlation with CRP(t=0.846, P=0.002)and PCT(t=0.701, P=0.002). ROC analysis showed that the 1-3-β-D glucan cut-off point value of 12.0 pg/mL, as used for the diagnosis of fungal rhinosinusitis, provided a sensitivity of 90.48%, a specificity of 95.12%, better than these of CRP and PCT. Conclusion Plasma 1-3-β-D glucan assay for diagnosis of fungal rhinosinusitis is reliable and it has potential to become a practical indicator for auxiliary preoperative diagnosis.

Key words: Diagnosis, C-reactive protein, 1-3-β-D glucan, Procalcitonin, Fungal rhinosinusitis

中图分类号: 

  • R765.4
[1] 章晓军, 周剑勇, 谭国鹏, 等. 42例非侵袭性真菌性鼻窦炎临床分析[J]. 中国耳鼻咽喉颅底外科杂志, 2013, 19(2):129-131. ZHANG Xiaojun, ZHOU Jianyong, TAN Guopeng, et al. Clinical analysis of non-invasive fungal rhinosinusitis in 42 cases[J]. Chin J Otolaryngol-skull Base Surgery, 2013, 19(2):129-131.
[2] Hou T Y, Wang S H, Liang S X, et al. The screening performance of serum 1,3-beta-D-Glucan in patients with invasive fungal diseases:a Meta-analysis of prospective cohort studies[J]. PLos One, 2015, 10(7):e0131602.
[3] 汤小军, 黄建春, 刘航, 等. 检测(1, 3)-β-D-葡聚糖在老年肺癌侵袭性肺部真菌感染中的临床价值[J]. 广西医学, 2014, 36(2):170-172. TANG Xiaojun, HUANG Jianchun, LIU Hang, et al. Clinical value of plasma(1, 3)-β-d-glucan detection for invasive fungal infections in aged patients with lung cancer[J]. Guangxi Medical Journal, 2014, 36(2):170-172.
[4] 刘少峰, 王文, 伍丽娟, 等. 单侧鼻腔鼻窦病变CT诊断与临床分析[J]. 中国耳鼻咽喉颅底外科杂志, 2012, 18(4):307-309. LIU Shaofeng, WANG Wen, WU Lijuan, et al. CT diagnosis and clinical analysis for unilateral nasal sinus lesions[J]. Chin J Otolaryngology-Skull Base Surgery, 2012, 18(4):307-309.
[5] 宋明艳, 李娜, 姜彦, 等. 真菌性鼻窦炎CT影像学的非特征性表现[J]. 山东医药, 2014, 54(29):93-94. SONG Mingyan, LI Na, JIANG Yan, et al. Non-distinctive features on CT scan of fungal sinusitis[J]. Shandong Med J, 2014, 54(29):93-94.
[6] Mendes Neto J A, Guerreiro V M, Hirai E R, et al. The role of maxillary sinus puncture on the diagnosis and treatment of patients with hospital-acquired rhinosinusitis[J]. Braz J Otorhinolaryngol, 2012, 78(4):35-41.
[7] Jain S, Das S, Gupta N, et al. Frequency of fungal isolation and antifungal susceptibility pattern of the fungal isolates from nasal polyps of chronic rhinosinusitis patients at a tertiary care centre in north India[J]. Med Mycol, 2013, 51(2):164-169.
[8] 戴勇传, 倪昊生. 非侵袭性真菌性鼻窦炎手术治疗的探讨[J]. 医学理论与实践, 2013, 26(20):2729-2730. DAI Yongchuan, NI Haosheng. The treatment of noninvasive surgery for fungal sinusitis[J]. J of Med Theory Prac, 2013, 26(20):2729-2730.
[9] Petraitiene R, Petraitis V, Bacher J D, et al. Effects of host response and antifungal therapy on serum and BAL levels of galactomannan and(1→3)-β-D-glucan in experimental invasive pulmonary aspergillosis[J]. Med Mycol, 2015, 53(6):558-568.
[10] Prattes J, Schilcher G, Krause R. Reliability of serum 1,3-beta- d -glucan assay in patients undergoing renal replacement therapy:a review of the literature[J]. Mycoses, 2014, 58(1):4-9.
[11] Raggam R B, Fischbach L M, Prattes J, et al. Detection of(1→3)-β-D-glucan in same-day urine and serum samples obtained from patients with haematological malignancies[J]. Mycoses, 2015, 58(7):394-398.
[12] 余鹏举, 黄媛媛, 江满杰, 等. 血浆1-3-β-D葡聚糖检测在真菌性鼻窦炎诊断中的临床价值[J]. 中国耳鼻咽喉颅底外科杂志, 2014(2):107-110. YU Pengju, HUANG Yuanyuan, JIANG Manjie, et al. Diagnostic value of plasma 1-3-β-D glucan assay in fungal rhinosinusitis[J]. Chin J Otolaryngology-Skull Base Surgery, 2014(2):107-110.
[13] Markanday A. Acute phase reactants in infections: evidence-based review and a guide for clinicians[J]. Open Forum Infect Dis, 2015, 2(3):ofv098.
[14] Davies J. Procalcitonin[J]. J Clin Pathol, 2015, 68(9):675-679.
[15] Carr J A. Procalcitonin-guided antibiotic therapy for septic patients in the surgical intensive care unit[J]. J Intensive Care, 2015, 3(1):36.
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