Utility of serum galactomannan antigen testing combined with chest computed tomography for early diagnosis of invasive pulmonary aspergillosis in patients with hematological malignancies with febrile neutropenia after antifungal drug treatment
Utility of serum galactomannan antigen testing combined with chest computed tomography for early diagnosis of invasive pulmonary aspergillosis in patients with hematological malignancies with febrile neutropenia after antifungal drug treatment
复制标题
血清半乳甘露聚糖抗原检测联合胸部计算机断层扫描在抗真菌药物治疗后伴发热性中性粒细胞减少的血液系统恶性肿瘤患者侵袭性肺曲霉病早期诊断中的应用
DOI：
10.1177/0300060518811472
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发表时间：
2019-02-01
影响因子：
1.6
通讯作者：
Zhang, Mei
中科院分区：
文献类型：
--
作者：
Wang, Xiaoning;Guo, Guili;Zhang, Mei
目的 探讨血清半乳甘露聚糖抗原（GM）检测联合胸部计算机断层扫描（CT）作为无创方法对抗真菌药物治疗后伴发热性中性粒细胞减少症的血液系统恶性肿瘤患者侵袭性肺曲霉病（IPA）早期诊断的价值。方法回顾性分析2015年1月至2017年8月收治的376例发热性中性粒细胞减少症患者的资料。所有患者均给予广谱抗生素治疗，分为对照组（抗生素治疗有效，不给予抗真菌药物）和观察组（抗生素治疗无效，给予抗真菌药物）。比较两组的血清GM检测、胸部CT和微生物学检查结果。结果对照组和观察组GM检测IPA假阳性率分别为4.04%和8.65%，两组假阴性率分别为1.10%和9.62%。观察组65例、对照组11例具有典型CT影像特征。结论 临床每周筛查血清 GM 和胸部 CT 可能是发热性中性粒细胞减少症患者早期诊断 IPA 的有效组合方法，即使他们已经接受过抗真菌治疗。
Objective To investigate the value of serum galactomannan antigen (GM) testing combined with chest computed tomography (CT) as a noninvasive method for early diagnosis of invasive pulmonary aspergillosis (IPA) in patients with hematological malignancies with febrile neutropenia after antifungal drug treatment. Methods We retrospectively analyzed the data of 376 patients with febrile neutropenia from January 2015 to August 2017. All patients were given broad-spectrum antibiotics and divided into the control group (effective antibiotic treatment, no antifungal drugs given) and the observational group (ineffective antibiotic treatment, antifungal drugs given). The serum GM testing, chest CT, and microbiological examination findings were compared between the two groups. Results The false-positive rates of GM testing for IPA in the control and observational groups were 4.04% and 8.65%, respectively, and the false-negative rates in the two groups were 1.10% and 9.62%, respectively. Sixty-five patients in the observational group and 11 in the control group had typical features of CT imaging. Conclusion Clinical weekly screening of serum GM and chest CT may be an effective combined approach to the early diagnosis of IPA in patients with febrile neutropenia, even if they have undergone antifungal treatment.