摘要目的 探讨血清甘露聚糖结合凝集素(MBL)动态检测在诊断肺烟曲霉菌感染中的意义.方法 成年Wistar大鼠96只,雌雄各半,按随机数字表法随机分为3组,每组32只:(1)对照组:未免疫抑制,未接种烟曲霉菌;(2)感染组(免疫抑制+接种烟曲霉菌):采用地塞米松0.6 mg/kg肌肉注射×3d,通过双侧鼻孔分别滴入烟曲霉菌孢子(1×107 cfu/ml),建立大鼠肺曲菌病模型;(3)定植组:仅双侧鼻孔分别滴入烟曲霉菌孢子.对照组及定植组分别于接种完成后第3、7、14、28天处死大鼠8只,感染组实验中有大鼠死亡,第3、7、14、28天分别处死8、7、5、6只,取心脏血通过酶联免疫吸附(ELISA)法检测MBL水平;部分肺组织进行病理学检查及比较.结果 感染组大鼠总体血清MBL水平显著高于定植组[(8.57±0.88)比(7.87±0.45) ng/ml],且二者均显著高于对照组的(7.32±0.41)ng/ml(均P＜0.05);结合感染组与定植组试验数据绘制MBL的ROC曲线,曲线下面积为0.744(P=0.002).MBL对肺曲菌病诊断的敏感度为75.0％,特异度为86.7％,阳性预测值为87.1％,阴性预测值为74.3％.第3、7天时定植组及感染组大鼠肺组织均可见炎性细胞,第14天感染组肺组织中可见真菌菌丝.结论 动态检测血清MBL可作为肺部烟曲霉菌感染的一个辅助诊断指标.

abstractsObjective To explore the effects of mannose-binding lectins (MBL) in pulmonary aspergillosis.Methods A total of 96 adult Wistar rats were randomly divided into 3 groups of aspergillus fumigatus (A.fumigatus) pulmonary,colonization and normal (n =32 each).An intramuscular injection (0.6 mg/kg × 3 d) of dexamethasone sodium phosphate and a nostril drop (1 × 107 cfu/ml) were administered for modeling.The animals were sacrificed at Days 3,7,14 and 28 post-inoculation and blood samples were obtained by cardiac puncture for MBL detection.Lung tissues were prepared for routine pathology examinations.The lung tissues infected with A.fumigatus showed remarkable inflammatory reactions.The serum value of MBL was detected by enzyme-linked immunosorbent assay (ELISA).And the results were compared and analyzed.Results All infected lung tissues showed remarkable inflammatory reactions.The serum MBL levels of A.fumigatus pulmonary and colonization groups were (8.57 ±0.88) and (7.87 ± 0.45) ng/ml and both significantly increased compared with non-pulmonary aspergillosis group (P ＜ 0.05).The area under the curve was 0.744 (P =0.002).The diagnosis of MBL had a sensitivity of 75.0％,a specificity of 86.7％,a positive predictive value of 87.1％ and a negative predictive value of 74.3％ for pulmonary aspergillosis.The inflammatory cells infiltration were detected in pathology in infection and colonization groups at Day 3 and Day 7.Conclusion The detection of serum MBL may be used for the diagnosis of pulmonary aspergillosis.