ASPERGILLUS ANTIGENURIA COMPARED TO ANTIGENEMIA IN BONE-MARROW TRANSPLANT RECIPIENTS
ASPERGILLUS ANTIGENURIA COMPARED TO ANTIGENEMIA IN BONE-MARROW TRANSPLANT RECIPIENTS
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DOI：
10.1007/bf01971310
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发表时间：
1994-07-01
影响因子：
4.5
通讯作者：
RATH, PM
中科院分区：
文献类型：
--
作者：
ANSORG, R;VONHEINEGG, EH;RATH, PM
用乳胶曲霉凝集试验(Pastorex)检测26例骨髓移植受者尿半乳甘露聚糖抗原。对原设计用于血清检测的方法进行改进后，对天然尿样的检出限约为20 ng/ml，217份系列尿样中有79份(36.4%)检出抗原，而340份血清标本中有40份(11.8%)检出抗原。通常，抗原性尿先于抗原血症，且持续时间更长。抗原尿对尸检证实的曲霉病和临床疑似曲霉菌感染的敏感性、特异性、阳性预测值和阴性预测值分别为57%、53%、31%和77%，抗原血症的敏感性、特异性、阳性预测值和阴性预测值分别为43%、53%、25%和71%。因此，尿液检测比血清检测更可靠。然而，无论是在血清中还是在尿液中检测抗原，都不能明确区分曲霉菌感染和接触非传染性曲霉菌抗原。
The detection of galactomannan antigen in urine was investigated in 26 bone marrow transplant recipients using an Aspergillus latex agglutination test (Pastorex). After modification of the method, which was originally devised for serum testing, the detection limit in native urine was approximately 20 ng/ml. Antigen was found in 79 (36.4 %) of 217 serial urine samples, compared to 40 (11.8 %) of 340 serum samples. As a rule, antigenuria preceded antigenemia and was more persistent. The sensitivity, specificity, positive predictive value and negative predictive value of antigenuria for autopsyproven aspergillosis and clinically suspected Aspergillus infection were 57 %, 53 %, 31 % and 77 %, respectively, while those of antigenemia were 43 %, 53 %, 25 % and 71 %. It is concluded that urine testing is more reliable than serum testing for the detection of Aspergillus galactomannan. The detection of antigen, however, whether in serum or in urine, allows no clear distinction between Aspergillus infection and exposure to noninfectious Aspergillus antigens.