非中性败血症侵袭性肺曲霉菌病患者中曲霉菌特异性 IgG 的血清流行率和预后价值:一项前瞻性多中心研究。

IF 8.5 Q1 RESPIRATORY SYSTEM
Meng-Rui Lee, Hsu-Liang Chang, Yung-Hsuan Chen, Chia-Jung Liu, Li-Ta Keng, Hung-Ling Huang, Jann-Yuan Wang, Chau-Chyun Sheu, Inn-Wen Chong
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引用次数: 0

摘要

背景:本研究旨在评估曲霉菌特异性IgG(Asp-IgG)对非中性偏瘫非血液病患者侵袭性肺曲霉菌病(IPA)的诊断和预后价值:2019年11月至2022年2月期间,我们从台湾招募了40名非中性非血液病IPA患者,并使用Thermofisher公司的Phadia检测血清Asp-IgG水平。Asp-IgG检测结果大于40 mgA/L即为阳性。我们评估了Asp-IgG水平与IPA患者总生存率和90天死亡率之间的关系:在40名参与者中,11人(27.5%)的Asp-IgG检测呈阳性,16人(40%)的半乳甘露聚糖抗原呈阳性(光密度大于1)。在多变量考克斯回归中,Asp-IgG水平越高,总生存率越高(HR:0.22,95% CI:0.05-0.99,p = 0.035)。90天总死亡率为65%(26/40)。我们发现,与 Asp-IgG 水平高的患者相比,Asp-IgG 水平低(≤ 40 mgA/L)的患者 90 天死亡率略高(OR:3.15,95% CI:0.75-13.28,p = 0.118)。根据血清半乳甘露聚糖和曲霉菌 IgG 水平进行分层,血清 GM 升高和 Asp-IgG 水平低的患者 90 天死亡率最高(80%,8/10),其次是血清 GM 低和 Asp-IgG 水平低的患者(68.4%,13/19):结论:约四分之一的非中性IPA患者Asp-IgG呈阳性。Asp-IgG有可能成为IPA的临床预后因素。需要进一步研究来验证这一发现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Seroprevalence and prognostic value of Aspergillus-specific IgG among non-neutropenic invasive pulmonary aspergillosis patients: a prospective multicenter study.

Background: This study aimed to assess the diagnostic and prognostic value of Aspergillus-specific IgG (Asp-IgG) for invasive pulmonary aspergillosis (IPA) in non-neutropenic non-hematologic patients.

Methods: Between November 2019 and February 2022, we recruited 40 non-neutropenic, non-hematologic IPA patients from Taiwan and measured serum Asp-IgG levels using Phadia, Thermofisher. A positive Asp-IgG test was defined as a level > 40 mgA/L. We evaluated the association between Asp-IgG levels and overall survival, as well 90-day mortality rate of IPA patients.

Results: Of the 40 participants, 11 (27.5%) tested positive for Asp-IgG, while 16 (40%) had positive galactomannan antigen (optical density > 1). Higher Asp-IgG levels were associated with improved overall survival (HR: 0.22, 95% CI: 0.05-0.99, p = 0.035) in multivariable Cox regression. The overall 90-day mortality rate was 65% (26/40). We found that patients with low Asp-IgG levels (≤ 40 mgA/L) had a borderline higher 90-day mortality rate compared to patients with high Asp-IgG levels (OR: 3.15, 95% CI: 0.75-13.28, p = 0.118). Stratifying by serum galactomannan and Aspergillus IgG levels, patients with elevated serum GM and low Asp-IgG had the highest 90-day mortality (80%, 8/10), followed by patients with low serum GM and low Asp-IgG (68.4%, 13/19).

Conclusions: Asp-IgG was positive in approximately one-fourth of non-neutropenic IPA patients. Asp-IgG may hold potential as a clinical prognostic factor for IPA. Further studies are required to validate this finding.

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来源期刊
Pneumonia
Pneumonia RESPIRATORY SYSTEM-
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1.50%
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7
审稿时长
11 weeks
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