关键词: 肺疾病,慢性阻塞性, 肺疾病,真菌性, 显微镜检查,荧光, β葡聚糖类;, 评价研究

Abstract:

Objective To investigate the diagnostic value of fluorescent staining combined with 1,3-β-D glucan (G) test in chronic obstructive pulmonary disease (COPD) complicated with invasive pulmonary fungal infection (IPFI). Methods A total of 174 patients diagnosed with COPD in the Second Affiliated Hospital of Wannan Medical College from January to December 2019 who failed to relieve clinical symptoms and the body temperature did not drop at 38℃ or rose again after 5 days of standard treatment with broad-spectrum antibiotics were collected as subjects for the study. Eighty-one cases with confirmed IPFI and with proposed IPFI were taken as the observation group, and 93 cases without IPFI were taken as the control group. The results of sputum or alveolar lavage were analyzed by fluorescent staining, and the peripheral blood were detected by G test and procalcitonin (PCT). The detection efficiency of various detection techniques was compared. Results Based on the clinical diagnosis results as the reference standard, the receiver operating characteristic (ROC) curve analysis showed that the sensitivity and specificity of fluorescent staining were 81.6% and 87.3%, respectively, which were higher than those of G test (81.5% and 78.3%) and PCT test (74.9% and 73.1%). The sensitivity and specificity of fluorescent staining combined with G test were 96.2% and 76.3%, respectively, the positive predictive value and negative predictive value were 83.1% and 88.7%, respectively, and the area under the curve (AUC) was 0.894, which was significantly superior to all the individual detection efficiency. Conclusion Fluorescence staining method has good detection efficiency in detecting COPD accompanying with IPFI, and its combined with G test can effectively improve the diagnostic rate.

Key words: Pulmonary disease,chronic obstructive, Lung diseases,fungal, Microscopy,fluorescence, beta-Glucans, Evaluation studies