在COVID-19相关的肺性阿斯伯吉洛症中进行气管吸气银曼南测试
Carla M Román-Montes1,2, Saúl Bojorges-Aguilar1,2, Paulette Díaz-Lomelí1
1Clinical Microbiology Laboratory, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Mexico City, Mexico.
气管吸入物银河体曼南检测显示,与支气管支气管洗对诊断COVID-19相关的肺性阿斯伯吉洛症有适度的一致性. 这表明气管吸管检测可以帮助排除CAPA,当支气管镜无法使用时.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 肺部病理学 肺部病理学
背景情况:
- 与COVID-19相关的肺阿斯伯吉洛症 (CAPA) 是重症患者的一种严重并发症.
- 标准的诊断方法,如支气管支气管洗 (BAL) 银河 (GM) 测试在疫情期间是有限的.
- 关于在替代呼吸器标本中进行转基因检测的数据有限.
研究的目的:
- 为了比较BAL和气管吸附液 (TA) 样本之间的银河 (GM) 测试的一致性,用于诊断CAPA.
- 为了评估TA GM测试的诊断性能.
主要方法:
- 对疑似CAPA的重症COVID-19患者的回顾性分析.
- 在配对的BAL和TA样本中比较转基因水平.
- 使用科恩的卡帕系数评估的协议.
- 诊断性能指标 (灵敏度,特异性,PPV,NPV,准确性) 计算为TA GM.
主要成果:
- 在BAL GM和TA GM之间发现了适度的协议 (Kappa = 0.47).
- 泰基基因基因表现出75%的灵敏度,81.2%的特异性,50%的PPV和92.8%的NPV.
- 五名患者 (9%) 符合可能的CAPA.标准.
- 与非CAPA患者 (40%) 相比,CAPA患者 (60%) 的死亡率更高,尽管在统计学上并不显著.
结论:
- 气管吸气转基因测试显示,对于CAPA诊断,BAL GM与中度一致.
- 泰基因基因检测具有高负预测值,使其在支气管镜检查不可行时用于排除CAPA.
- 在资源有限的环境中或在流行病期间,TA GM可能作为一种有价值的替代诊断工具.
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