目的：观察侵袭性肺曲霉菌（Invasive pulmonary aspergillosis，IPA）感染患者CT影像学特征与肺泡灌洗液半乳甘露聚糖（Galactomannan，GM）实验阳性率之间的关系。方法：纳入120例确诊IPA感染患者，单因素Logistic回归分析CT侵犯肺叶数、空气新月征、晕轮征与肺泡灌洗液GM的关系。结果：IPA感染患者CT侵犯肺叶数、晕轮征与肺泡灌洗液GM实验阳性率显著相关。结论：CT影像学特征与肺泡灌洗液GM实验阳性率显著相关。
Abstract
Objective: To evaluate relationship between CT imaging features and positive bronchoalveolar galactomannan(GM) for invasive pulmonary aspergillosis(IPA). Methods: One hundred and twenty patients with IPA were enrolled in this study． The levels of GM were measured in bronchoalveolar lavage(BAL)． Univariate logistic regression analysis was performed with GM in BAL and involved lung lobe number, existence of air crescent sign and halo sign． Result: The positive rate of GM in BAL is correlated with the number of involved lung lobes and existence of halo sign on CT. Conclusion: GM in BAL may be an important marker for diagnosing IPA, and GM in BAL is correlated with CT features.
关键词
曲霉菌病；支气管肺泡灌洗液；体层摄影术 /
螺旋计算机
Key words
Aspergillosis /
Bronchoalveolar lavage fluid /
Tomography, spiral computed
中图分类号：
Ｒ563
Ｒ519.8
R814.42
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参考文献
[1]Leeflang MM, Debets-Ossenkopp YJ, Wang J, et al. Galactomannan detection for invasive aspergillosis in immunocompromised patients[J]. Cochrane Database Syst Rev, 2015, 30(12): CD007394.
[2]Thornton CR. Breaking the mould—novel diagnostic and therapeutic strategies for invasive pulmonary aspergillosis in the immune deficient patient[J]. Expert Rev Clin Immunol, 2014, 10(6): 771-780.
[3]Tsitsikas DA, Morin A, Araf S, et al. Impact of the revised(2008) EORTC/MSG definitions for invasive fungal disease on the rates of diagnosis of invasive aspergillosis[J]. Med Mycol, 2012, 50(5): 538-542.
[4]Guo YL, Chen YQ, Wang K, et al. Accuracy of BAL galactomannan in diagnosing invasive aspergillosis: a bivariate Meta analysis and systematic review[J]. Chest, 2010, 138(4): 817-824.
[5]Swoboda KE, Sikora M, Piskorska K, et al. Diagnosis of Invasive Pulmonary Aspergillosis[J]. Adv Exp Med Biol, 2016, 1(6): 1-12.
[6]Mohammadi S, Khalilzadeh S, Goudarzipour K, et al. Bronchoalveolar galactomannan in invasive pulmonary aspergillosis: a prospective study in pediatric patients[J]. Med Mycol, 2015, 53(7): 709-716.
[7]Maertens J, Maertens V, Theunissen K, et al. Bronchoalveolar lavage fluid galactomannan for the diagnosis of invasive pulmonary aspergillosis in patients with hematologic diseases[J]. Clin Infect Dis, 2009, 49(11): 1688-1693.
[8]Choi SH, Kang ES, Eo H, et al. Aspergillus galactomannan antigen assay and invasive aspergillosis in pediatric cancer patients and hematopoietic stem cell transplant recipients[J]. Pediatr Blood Cancer, 2013, 60(2): 316-322.
[9]Kuhlman JE, Fishman EK, Siegelman SS. Invasive pulmonary aspergillosis in acute leukemia: characteristic findings on CT, the CT halo sign, and the role of CT in early diagnosis[J]. Radiology, 1985, 157(3): 611-614.
基金
宜昌市医疗卫生科研基金项目（KFJ2013009）
