目的 初步探讨慢性肺曲霉病(chronic pulmonary aspergillosis, CPA)患者血清曲霉特异性IgG抗体对预后的判断价值。方法 回顾性分析2017-03至2019-02收治的27例CPA患者,根据治疗后第90天情况分为改善组(19例)和进展组(8例)。所有患者入院后进行第1个24 h的急性生理与慢性健康评估Ⅱ(APACHEII)评分,并采用ELISA法检测血清曲霉特异性IgG抗体及血常规、G试验、GM试验等。比较两组患者入院后APACHEII评分、白细胞计数、中性粒细胞、血小板计数、C反应蛋白(CRP)、降钙素原(PCT)、血清G试验、GM试验,以及曲霉特异性IgG抗体值水平。评估其对预后的预测效果。结果 两组患者入院第1个24 h的APACHEII评分差异无统计学意义;入院后的血白细胞计数、中性粒细胞、血小板计数、CRP、PCT、血清G试验、GM试验水平相近。进展组血清特异性IgG水平为(178.8±24.6)AU/ml,明显高于改善组的(122.3±19.5)AU/ml,差异有统计学意义(t=-3.625,P＜0.05)。结论 血清曲霉特异性IgG值可作为CPA患者预后判断的有用指标。
Abstract
Objective To assess the value of serum anti-aspergillus IgG antibody in predicting the prognosis of patients with chronic pulmonary aspergillosis (CPA).Methods The clinical data on 27 cases of chronic pulmonary aspergillosis treated between March 2017 and February 2019 was retrospectively analyzed. According to their conditions 90 days after treatment, these patients were divided into the improvement group (19 cases) and progress group (8 cases). After admission, all the patients were assessed in terms of Acute Physiology and Chronic Health Evaluation II (APACHEII) scores for the first 24 hours. Serum aspergillus specific IgG antibody was detected by ELISA, and blood routine test, serum-G and serum-GM test were conducted. APACHEII scores, white blood cell count, neutrophil count, platelet count, C-reactive protein (CRP), procalcitonin (PCT), serum-G, serum-GM assay and aspergillus specific IgG antibody levels were compared between the two groups after admission. The predictive value for prognosis was determined.Results There was no significant difference in APACHEII scores between the two groups during the first 24 hours of admission. After admission, the levels of leukocyte count, neutrophil, platelet count, CRP, PCT, serum-G and serum-GM assay in these two groups were similar. The serum specific IgG level in the progress group was (178.8±24.6)AU/ml, which was significantly higher than that of the improvement group (122.3±19.5) AU/ml (t=-3.625,P＜0.05).Conclusions Serum aspergillus specific IgG can be used as a useful prognostic indicator of prognosis for patients with chronic pulmonary aspergillosis.
关键词
慢性肺曲霉病 /
血清曲霉特异性IgG抗体 /
预后
Key words
chronic pulmonary aspergillosis /
serum specific anti-aspergillus IgG antibody /
prognosis
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