余进：侵袭性真菌病诊断进展.pdf

侵袭性真菌病诊断进展 北京大学第一医院 北京大学真菌和真菌病研究中心 余进 Dept. Dermatology, Peking University First Hospital and Research Center for Medical Mycology, Peking University Dept. Dermatology, Peking University First Hospital and Research Center for Medical Mycology, Peking University 侵袭性真菌病的诊断方法 传统诊断方法 —真菌直接镜检 —真菌培养 血清学方法 分子生物学方法 Dept. Dermatology, Peking University First Hospital and Research Center for Medical Mycology, Peking University Dept. Dermatology, Peking University First Hospital and Research Center for Medical Mycology, Peking University 新型检查方法 • 真菌细胞壁成分 – （1-3） - β- D-葡聚糖检测（G试验） • 真菌抗原检查 – 半乳甘露聚糖（galactomannan) 抗原（GM试 验) – 隐球菌荚膜多糖抗原（乳胶凝集试验） – 甘露聚糖/甘露聚糖抗体（M/AM) • 真菌 DNA 的检测 Dept. Dermatology, Peking University First Hospital and Research Center for Medical Mycology, Peking University Dept. Dermatology, Peking University First Hospital and Research Center for Medical Mycology, Peking University β （ ） 葡聚糖检测 - 1-3 - D- Dept. Dermatology, Peking University First Hospital and Research Center for Medical Mycology, Peking University Dept. Dermatology, Peking University First Hospital and Research Center for Medical Mycology, Peking University BG检测的特点 • 可检测多种致病真菌感染 – 念珠菌, 曲霉,肺孢子菌,镰刀菌,地霉,组织胞浆菌, 毛孢子菌等 – 不能用于检测隐球菌和接合菌感染 • 阳性结果代表存在侵袭性真菌感染 • 真菌对数生长期释放量最大 ,可被体内葡聚糖 酶降解(glucanase) • 每周检测2次 Dept. Dermatology, Peking University First Hospital and Research Center for Medical Mycology, Peking University Dept. Dermatology, Peking University First Hospital and Research Center for Medical Mycology, Peking University （1-3） - β- D-葡聚糖(BG) 检测方法 • colorimetric – Fungitec-G (Japan Seikagaku) – Fungitell/Glucatell (US Associ