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开展隐球菌荚膜抗原检测对肺隐球菌病诊疗的影响▲
Effects of implementing cryptococcal capsular antigen detection on the diagnosis and treatment of pulmonary cryptococcosis

内科 202419卷04期 页码:377-380

作者机构:1广西壮族自治区人民医院呼吸与危重症医学科,南宁市 530021;2前海人寿广西医院呼吸内科,南宁市 530200;3中山大学附属第一医院广西医院呼吸与危重症医学科,南宁市 530022;4广西壮族自治区人民医院检验科,南宁市 530021

基金信息:广西壮族自治区卫生健康委员会自筹经费课题(Z20201027);广西壮族自治区卫生和计划生育委员会自筹经费科研课题(Z2016651) 通信作者:秦志强

DOI:10.16121/j.cnki.cn45⁃1347/r.2024.04.05

  • 中文简介
  • 英文简介
  • 参考文献

目的 探讨开展隐球菌荚膜抗原(CrAg)检测对肺隐球菌病(PC)诊疗的影响。方法 回顾性分析2015年1月1日至2021年12月31日广西壮族自治区人民医院呼吸与危重症医学科门诊及住院诊断的141例PC患者(均为血HIV抗体阴性)的临床资料。比较开展CrAg检测前后(2018年6月开展CrAg检测)门诊诊断PC情况、住院诊断PC患者占同期出院患者的比例,以及开展CrAg检测前后住院PC患者病原学诊断方式的变化。结果 开展CrAg检测前,并无门诊临床诊断PC的病例;开展CrAg检测后,39例患者在门诊诊断PC。开展CrAg检测后,住院诊断PC的患者占同期出院患者的比例较开展前增加[11.3‰(74/6 522)比3.8‰(28/7 449),P<0.05],通过经皮肺穿刺活检来诊断PC的患者比例较开展前下降[43.2%(32/74)比75.0%(21/28),P<0.05]。结论 开展CrAg检测使部分PC患者在门诊即得到诊断和治疗,同时提高了住院患者的PC诊断率,有助于减少有创性操作。

Objective To explore the effects of implementing cryptococcal capsular antigen (CrAg) detection on the diagnosis and treatment of pulmonary cryptococcosis (PC). Methods A retrospective analysis was conducted on the clinical data of 141 patients (all blood HIV antibodies-negative) with PC diagnosed in the outpatient and inpatient settings of the Department of Respiratory and Critical Care Medicine of the People's Hospital of Guangxi Zhuang Autonomous Region from January 1, 2015 to December 31, 2021. The outpatient diagnosis of PC before and after implementing the CrAg detection (which was carried out in June 2018) and the proportion of PC patients diagnosed in the inpatient setting in the discharged patients in the same period were compared, while changes in the pathogenic diagnosis of PC in inpatients before and after implementing the CrAg detection were observed. Results Before implementing the CrAg detection, there was no PC patient diagnosed in the outpatient setting; after implementing the CrAg detection, 39 PC patients were diagnosed in the outpatient setting. After implementing the CrAg detection, the proportion of PC patients diagnosed in the inpatient setting in the discharged patients in the same period increased [11.3‰ (74/6,522) vs. 3.8‰ (28/7,449), P<0.05], and the proportion of PC patients diagnosed by percutaneous lung biopsy was lower compared with that before implementing the detection [43.2% (32/74) vs. 75.0% (21/28), P<0.05]. Conclusion The implementation of CrAg detection enables some PC patients to be diagnosed and treated in the outpatient setting and improves the PC diagnosis rate of inpatients, which helps to reduce invasive operations.

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