Study on the diagnosis of pulmonary aspergillosis in patients with non-granulocyte deficiency by GM detection of bronchial alveolar lavage / 中国医师杂志

ABSTRACT

Objective To evaluate the diagnostic effect of galactomannan (GM) on bronchial alveolar lavage in patients with non-granulocyte deficiency.Methods 64 patients with suspected invasive pulmonary aspergill were enrolled in our hospital from May 2016 to May 2017.According to the relevant diagnostic criteria,they were divided into the diagnosis group (n =3),the clinical diagnosis group (n =20),the proposed group (n =14) and non-fungal infection group (n =27).All subjects underwent bronchial alveolar lavage and GM testing.Results When the GM value of bronchoalveolar lavage fluid and serum GM value increased from 0.5 to 1,the sensitivity decreased,while the specificity and positive predictive value increased.The sensitivity,positive predictive value and negative predictive value of GM detection method for bronchial alveolar lavage fluid were significantly higher than that of serum GM (P ＜ 0.05) at the same GM boundary value,and the specificity was significantly lower than that of serum GM (P ＜ 0.05).When the GM boundary value of bronchial alveolar lavage fluid was ≥ 0.86,the diagnostic efficiency of invasive pulmonary aspergillosis was the highest,the sensitivity and specificity reached 80.26％,75.15％,and the area under the curve was 0.945 (95％ CI0.782-0.986).Conclusions GM detection of bronchial alveolar lavage fluid is more helpful for the diagnosis of invasive pulmonary aspergillosis in patients with non-granulocyte deficiency than serum GM.The optimal threshold is 0.86.