目的评估脑脊液中(1,3)-β-D-葡聚糖(BDG)含量测定对颅内真菌感染的辅助诊断价值,以及动态监测对病情变化的监测价值。方法选取已确诊的真菌性脑膜炎10例作为观察组,平行设立非真菌感染对照组,使用MB-80微生物快速动态监测系统对观察组与对照组的患者进行脑脊液BDG含量测定,并动态监测BDG变化与临床病情转归的相关性。结果颅内真菌感染患者脑脊液BDG明显增高,与对照组差异具有统计学意义(P〈0.05)。随着患者病情改善,脑脊液BDG浓度随着治疗时间的延长逐渐下降。结论脑脊液中BDG定量测定是颅内真菌感染早期诊断敏感性指标,具有辅助诊断价值;BDG水平与疗效疗程相关。
Objective To evaluate the utility of(1,3)-β-D-glucan(BDG)as an assist diagnostic tool for patients infected with fungal meningoencephalitis.To investigate the change of BDG level following the administration of antifungal drug in fungal meningoencephalitis patients,evaluate the monitor value of BDG in cerebrospinal fluid(CSF)for fungal meningoencephalitis.Methods BDG concentrations of 10 cerebrospinal fluid(CSF)specimens from confirmed cases of fungal meningoencephalitis,and 30 negative control CSF specimens were tested.And we also assessed whether BDG levels correlate with clinical status by using incident samples from 10 patients with serially collected CSF.Results The level of BDG in CSF was obviously rise in those confirmed cases of fungal meningoencephalitis,the data had a statistically significant difference(P〈0.05).Patients with serially collected CSF displayed that patients with a decline in CSF BDG had clinical improvement.Conclusions Our data suggest that measuring BDG in CSF is a highly sensitive test for diagnosis of fungal meningoencephalitis.Analysis of BDG levels in serially collected CSF demonstrated that BDG may correlate with clinical response and course of treatment.Routine measurement of BDG in CSF may provide useful adjunctive data for the clinical management of patients with meningoencephalitis.