目的 探讨高分辨CT联合半乳甘 露聚糖含量检测(GM试验)在免疫功能低下 患者肺曲霉菌感染早期诊断的价值。方法 收集高度怀疑继发侵袭性肺曲霉病的免疫 功能低下患者96例，确诊后分为感染组39 例和非感染组57例，采用HRCT扫描肺部， 分析CT征象，同时GM试验检测患者血清半 乳甘露聚糖含量，分为阳性病例及阴性病 例，统计肺部HRCT和血清GM试验单独和联 合应用诊断侵袭性肺曲霉病的敏感性、 特异性、阳性预测值和阴性预测值。结 果 HRCT诊断侵袭性肺曲霉病的敏感性、 特异性、阳性预测值和阴性预测值分别是 66.7%、87.7%、78.8%、73.5%；血清GM试 验分别是82.1%、91.2%、86.3%、88.1%； HRCT和血清GM试验并联分别是94.5%、 82.5%、78.7%、96.0%；HRCT和血清GM试 验串联分别是61.5%、94.7%、88.9%、 78.3%。结论 相对于HRCT和血清GM试验单 独使用，HRCT和血清GM试验并联诊断免疫 功能低下患者继发IPA的灵敏性和阴性预 测值更高，串联分析时特异性、阳性预测 值更高，联合应用有利于提高诊断效能。

Objective To investigate the early diagnostic value of HRCT combined with GM test for pulmonary aspergillosis infections in immunocompromised patients. Methods 96 immunocompromised patients who suspected to suffer invasive pulmonary aspergillosis had been collected, and divided into two groups after diagnosed, including infection group (39 cases) and non-infection group (39 cases). HRCT scan was used to analyze the signs of pulmonary CT. At the same time, GM test was used to detect the content of galactomannan in patients, which were divided into positive and negative cases. Statistics of lung HRCT and serum GM test alone and combined diagnostic sensitivity, specificity, positive predictive value of invasive pulmonary aspergillosis and negative predictive value. Results Sensitivity, specificity, positive predictive value and negative predictive value of invasive pulmonary aspergillosis diagnosed by HRCT are 66.7%, 87.7%, 78.8%, 73.5%. Serum GM test, respectively, 82.1%, 91.2%, 86.3%, 88.1%; The HRCT and serum GM tests parallel connection, respectively, 94.5%, 82.5%, 78.7%, 96.0%. HRCT and serum GM test series connection, respectively, 61.5%, 94.7%, 88.9%, 78.3%. Conclusion Relative to HRCT and serum GM tests used alone to diagnosis of secondary IPA of immunocompromised patients, Sensitivity and negative predictive value of HRCT and serum GM test parallel analysis are higher, and the specificity and positive predictive value of tandem analysis were higher, so the combined use of HRCT and GM tests was beneficial to improve the diagnostic efficacy.