نوع مقاله : مقاله پژوهشی

نویسندگان

1 کارشناسی ارشد، بخش بیوشیمی، دانشگاه آزاد اسلامی واحد شیراز، شیراز، ایران

2 استادیار، مولکولار پاتولوژی و سیتوژنتیک، بخش پاتولوژی، دانشکده پزشکی، دانشگاه علوم پزشکی شیراز، شیراز، ایران

3 استادیار، بخش هماتولوژی و انکولوژی، بخش داخلی، دانشکده پزشکی، دانشگاه علوم پزشکی شیراز، شیراز، ایران

4 کارشناسی ارشد، درمانگاه شهید مطهری، بخش پاتولوژی، دانشگاه علوم پزشکی شیراز، شیراز، ایران

چکیده

مقدمه: بیماری های قارچی مهاجم با افزایش مرگ و میر بیماران دارای بدخیمی های خون  در ارتباط می باشد.از این رو تشخیص و درمان به موقع  بیماری های قارچی در این بیماران ضروری  بوده و میتواند مرگ و میر آنها را کاهش دهد.با توجه به تهاجمی و زمان بر بودن روش های تشخیص قطعی تشخیص عفونتهای قارچی، روشهای سریع تر و غیر تهاجمی مانند روشهای سرولوژیک تشخیصی میتوانند به عنوان روش های کمکی در ارزیابی عفونت های فرصت طلب در بیماران دارای نقص سیستم ایمنی استفاده شوند. این روش های تشخیصی جدید،تشخیص زود هنگام و به دنبال ان امکان درمان به موقع را فراهم می کند.
روش‌ها: برای انجام این مطالعه، نمونه خون 68 بیمار مبتلا به بدخیمی های خونی مشکوک به عفونت های قارچی، جهت انجام تست تشخیصی آنتی ژن بتا دی گلوکان به روش الیزا مورد بررسی قرار گرفت و ارتباط مثبت شدن تست با نوع بدخیمی و همچنین علامتهای بالینی و پاراکلینیکی بررسی گردید.
یافته‌ها: در بین بیماران 43 نفر مرد و 25 نفر زن بودند و تست مثبت در 79% موارد مشاهده گردید.
نتیجه گیری: هرچند نتایج این مطالعه حاکی از عدم  ارتباط نوع بدخیمی، علائم بالینی و یافته های پاراکلینیکی با مثبت شدن تست بتا دی گلوکان بود. با در نظر گرفتن احتمال بالای موارد مثبت کاذب به علت احتمال عفونتهای باکتریال همزمان و مصرف آنتی بیوتیکها در بیماران دارای ضعف سیستم ایمنی، نتایج این مطالعه نشان داد که ارزیابی بتا دی گلوکان تست مناسبی برای تشخیص زود هنگام بیماری های قارچی مهاجم در بیماران دارای سرطان خون نمی باشد. 

کلیدواژه‌ها

عنوان مقاله [English]

Efficacy of Beta D- Glucan Serologic Test in Invasive Fungal Infections Early Detection in Patients with Hematologic Malignancies in Southern Iran

نویسندگان [English]

  • Elahe Zahedi 1
  • Amir Reza Dehghanian 2
  • Alireza Rezvani 3
  • Aboozar Barzegar 4

1 M.Sc., Department of Biochemistry, Shiraz Branch, Islamic Azad University, Shiraz, Iran

2 Assistant Professor, Molecular pathology and cytogenetics division, Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran

3 Assistant Professor, Department of Hematology and Medical Oncology, Shiraz University of Medical Sciences, Shiraz, Iran

4 M.Sc., Motahari Polyclinic, Department of Pathology, Shiraz University of Medical Sciences, Shiraz, Iran

چکیده [English]

Introduction: Fungal infections are a major concern in immunocompromised patients, such as patients with hematologic malignancies and bone marrow transplants. Opportunistic infections such as invasive fungal infections can lead to poor outcomes and a high probability of death in such patients. Gold standard methods of fungi detection are intrusive and time-consuming. Therefore, they may not be the method of choice to detect such infections rapidly; however, they are always mandatory. Next to gold-standard methods, serologic methods are rapid and non-invasive methods that have been approved for use as an adjunct to classic methods for quicker detection of fungal infections.
Methods: In this study, 68 patients diagnosed with hematologic malignancies and suspicious of fungal infection were enrolled to detect fungi with serologic testing of Beta D-Glucan using ELISA. The authors evaluated the association of malignancy type, clinical signs, and patients’ para-clinical data with positive Beta D-Glucan tests.
Results: Out of 43 men and 25 women participating in this study, 79% had positive test results.
Conclusion: There was no significant association between malignancy type, clinical signs, patients’ para-clinical data, and their positive serology tests. Considering the probable false-positive results due to infection and the use of certain antibiotics in such immunocompromised patients, the authors concluded that the Beta D-Glucan ELISA test might not be a sensitive diagnosis means to diagnose fungal infections in patients with hematologic malignancies.

کلیدواژه‌ها [English]

  • Hematologic Neoplasms
  • Invasive Fungal Infections
  • Beta-D-Glucan
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