标题：G实验和GM实验在咽喉部侵袭性真菌感染诊断中的应用价值

      作者：邓涛 1，尹黎波 1，姚晚霞 2，权博源 1，李萌 1，高腾 1    1.西安市中心医院耳鼻咽喉头颈外科，陕西 西安 710003；2.西安交通大学第一附属医院，陕西 西安 710061

      卷次： 2021年32卷13期

      【摘要】 目的 研究G实验和GM实验对咽喉部侵袭性真菌感染的诊断价值。方法 回顾性分析 2014年 6月至2017年5月期间就诊于西安市中心医院耳鼻咽喉头颈外科的38例咽喉部真菌感染患者(研究组)的临床资料，所有患者在抗真菌治疗前检测血清半乳甘露聚糖抗原(GM实验)、血清(1,3)-β-D-葡聚糖抗原(G实验)。依据纳入及排除标准，随机抽取同期住院治疗且确诊并排除真菌感染的45例患者作为对照组。结果 研究组G实验阳性16例(42.1%)，阴性22例(57.9%)，对照组G实验阳性5例(11.1%)，阴性40例(88.9%)，G试验在研究组与对照组血清(1,3)-β-D-葡聚糖抗原检测方面比较差异有统计学意义(P<0.05)；G试验的灵敏度为 42%，特异度为 89%；研究组GM实验阳性 3例(6.7%)，阴性 35例(92.1%)；对照组GM实验阳性 1例(2.2%)，阴性 44例(97.8%)，GM实验在研究组与对照组血清半乳甘露聚糖抗原检测方面比较差异无统计学意义(P>0.05)；GM实验灵敏度为 8%，特异度为 98%。结论 血清G试验用于咽喉部侵袭性真菌感染的早期筛查具有一定临床诊断价值，血清GM试验临床诊断价值有限。
      【关键词】 真菌感染；(l，3)-β-D-葡聚糖；半乳甘露聚糖；抗原；诊断价值
      【中图分类号】 R379 【文献标识码】 A 【文章编号】 1003—6350（2021）13—1642—03

Application value of G test and GM test in the diagnosis of invasive fungal infection of the pharynx and larynx.DENG Tao 1, YIN Li-bo1, YAO Wan-xia 2, QUAN Bo-yuan1, LI Meng 1, GAO Teng 1.
1. Department of Otolaryngology Headand Neck Surgery, Xi'an Central Hospital, Xi'an 710003, Shaanxi, CHINA; 2. First Affiliated Hospital of Xi'an JiaotongUniversity, Xi'an 710061, Shaanxi, CHINA
【Abstract】 Objective To explore the diagnostic value of G test and GM test for invasive fungal infection ofthe pharynx and larynx. Methods A retrospective analysis was conducted on the clinical data of 38 patients with fungalinfection of the pharynx and larynx, who were admitted to the Department of Otorhinolaryngology Head and Neck Sur-gery at Xi'an Central Hospital from June 2014 to May 2017. All patients were tested for serum galactomannan (GM) anti-gen and serum (1,3)-β-D-glucan (G) antigen before antifungal treatment. According to the inclusion and exclusion crite-ria, 45 patients with confirmed and excluded fungal infection in the same period were randomly selected as the controlgroup. Results The G test in the study group was positive in 16 cases (42.1%) and negative in 22 cases (57.9%). The Gtest in the control group was positive in 5 cases (11.1%) and negative in 40 cases (88.9%). There were statistically signifi-cant differences in the detection of serum (1,3)-β-D-glucan antigen between the study group and the control group (P<0.05), which had a sensitivity of 42% and specificity of 89%. The GM test in the study group was positive in 3 cases(6.7%) and negative in 35 cases (92.1%). The GM test in the control group was positive in 1 case (2.2%) and negative in44 cases (97.8%). The GM test showed no statistically significant difference in the detection of serum galactomannan an-tigen between the study group and the control group (P>0.05). The GM test had a sensitivity of 8% and specificity of98%. Conclusion Serum G test has certain clinical diagnostic value for early screening of invasive fungal infection ofthe pharynx and larynx, while serum GM test has limited clinical diagnostic value.
      【Key words】 Fungal infection; (1,3)-β-D-glucan; Galactomannan; Antigen; Diagnostic value