[1]何燕琴,唐 伟,张颖洁,等.感染性肺结节患者呼吸道微生态分析[J].医学信息,2024,37(17):64-68.[doi:10.3969/j.issn.1006-1959.2024.17.011]
　HE Yan-qin,TANG Wei,ZHANG Yin-jie,et al.Analysis of Respiratory Tract Microecology in Patients with Infectious Pulmonary Nodules[J].Journal of Medical Information,2024,37(17):64-68.[doi:10.3969/j.issn.1006-1959.2024.17.011]
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感染性肺结节患者呼吸道微生态分析()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
37卷
期数:
2024年17期
页码:
64-68
栏目:
论著
出版日期:
2024-09-01

文章信息/Info

Title:
Analysis of Respiratory Tract Microecology in Patients with Infectious Pulmonary Nodules
文章编号:
1006-1959（2024）17-0064-05
作者:
何燕琴; 唐 伟; 张颖洁; 石琳凤; 何美燕
西双版纳傣族自治州人民医院呼吸与危重症医学科，云南 西双版纳 666100
Author(s):
HE Yan-qin; TANG Wei; ZHANG Yin-jie; SHI Lin-feng; HE Mei-yan
Department of Respiratory and Critical Care Medicine,Xishuangbanna Dai Autonomous Prefecture People’s Hospital,Xishuangbanna 666100,Yunnan,China
关键词:
感染性肺结节; 呼吸道微生态; Alpha多样性
Keywords:
Infectious lung nodule; Respiratory microecology; Alpha diversity
分类号:
R563；R816.4
DOI:
10.3969/j.issn.1006-1959.2024.17.011
文献标志码:
A
摘要:
目的 分析感染性肺结节患者呼吸道微生态成分构成和变化。方法 收集2020年6月-2022年12月在我院呼吸与危重症医学科诊断和治疗的肺结节病患者共53例，根据临床诊断分为感染组（22例）和非感染组（31例）。收集肺泡灌洗液行宏基因组测序（mNGS）检测呼吸道微生物。比较两组患者呼吸道微生物Alpha多样性，以及各指数ROC和PRC曲线。结果 感染组Sobs指数、Chao1指数、Shannon指数均高于非感染组，而Simpson指数低于非感染组，但差异无统计学意义（P＞0.05）。感染组ACE指数高于非感染组，差异有统计学意义（P＜0.05）。非感染组以G阴性菌和病毒为主要微生物群落，感染组则以G阳性菌为主，差异有统计学意义（P＜0.05）。Sobs、Chao1和Simpson指数的错误率高于50%，仅ACE和Shannon指数错误率低于50%。ACE和Shannon指数用于诊断感染性肺结节的准确率、特异性、敏感性和精确度均高于其它指数。Sobs、Chao1、AEC、Shannon和Simpson指数ROC的AUC分别为0.396、0.394、0.569、0.582和0.449。PRC的AUC分别为0.476、0.474、0.562、0.647和0.511；联合检测ROC和PRC的AUC为0.482和0.520。结论 呼吸道微生态与感染性肺结节患者相关，对呼吸道微生物Alpha多样性分析可用于感染性肺结节患者临床诊断和治疗，具有一定的应用价值。
Abstract:
Objective To analyze the composition and changes of respiratory microecological components in patients with infectious pulmonary nodules.Methods A total of 53 patients with pulmonary sarcoidosis diagnosed and treated in the Department of Respiratory and Critical Care Medicine of our hospital from June 2020 to December 2022 were collected. According to the clinical diagnosis, they were divided into infection group (22 patients) and non-infection group (31 patients). Bronchoalveolar lavage fluid was collected for metagenomic sequencing (mNGS) to detect respiratory microorganisms. The Alpha diversity of respiratory microorganisms and the ROC and PRC curves of each index were compared between the two groups.Results The Sobs index, Chao1 index and Shannon index of the infected group were higher than those of the non-infected group, while the Simpson index was lower than that of the non-infected group, but the difference were not statistically significant (P>0.05). The ACE index of the infected group was higher than that of the non-infected group, and the difference was statistically significant (P<0.05). The non-infected group was dominated by G-negative and virus, while the infected group was dominated by G-positive bacteria, and the difference was statistically significant (P<0.05). The error rates of Sobs, Chao1 and Simpson indices were higher than 50%, and only ACE and Shannon indices were lower than 50%. The accuracy, specificity, sensitivity and accuracy of ACE and Shannon index in the diagnosis of infectious pulmonary nodules were higher than those of other indexes. The AUC of Sobs, Chao1, AEC, Shannon and Simpson index ROC were 0.396, 0.394, 0.569, 0.582 and 0.449, respectively. The AUC of PRC was 0.476, 0.474, 0.562, 0.647 and 0.511, respectively. The AUC of combined detection of ROC and PRC was 0.482 and 0.520.Conclusion Respiratory tract microecology is related to patients with infectious pulmonary nodules. The analysis of Alpha diversity of respiratory tract microorganisms can be used for clinical diagnosis and treatment of patients with infectious pulmonary nodules, which has certain application value.

参考文献/References:

[1]曹文军,薛洪省,汤敏,等.良性肺结节的临床特点及其诊断和治疗[J].中华胸部外科电子杂志,2020,7(1):22-29.[2]许仙花,陈孟川,翁叶萍,等.感染性肺结节影像-病理对照分析[J].诊断病理学杂志,2020,27(10):706-708.[3]滑炎卿.肺部感染与非感染性病变的CT鉴别诊断[J].上海医学影像,2009,18(4):347-349.[4]陈熔,王旭,舒静,等.特发性肺间质纤维化急性加重患者呼吸道微生态成分与不良预后的关系[J].疑难病杂志,2022,21(11):1141-1146.[5]王辉,叶彩虹,马焕丽,等.吸烟相关COPD肺微生态菌群、Treg/Th17、炎症在发病中的作用机制[J].分子诊断与治疗杂志,2021,13(7):1126-1129,1133.[6]张鹏,刘升明,刘宝仪,等.脓毒症肺内感染与肺外感染ARDS肺部微生态的异同[J].广东医学,2022,43(3):356-361.[7]任媛.不同激素条件下云南地区AECOPD患者呼吸道微生态研究[D].昆明:昆明理工大学,2023.[8]杨丽,李廷源,李良山,等.CT引导下肺穿刺活检术对老年孤立性肺结节的诊断及安全性分析[J].第三军医大学学报,2016,38(24):2643-2647.[9]王璐,洪群英.肺结节诊治中国专家共识(2018年版)解读[J].中国实用内科杂志,2019,39(5):440-442.[10]李冰.感染性肺结节的诊治[C]//中国生理学会.2019中国生理学会学术年会暨张锡钧基金第十五届全国青年优秀生理学学术论文交流会及第十三届全国青年生理学工作者学术会议论文摘要.同济大学,2019:2.[11]雷光焰,张艰,闫小龙.肺结节诊治西北地区专家共识(2021年版)[J].中国医药科学,2021,11(23):16-22,25.[12]覃鑫,胡量子.重症肺炎患者降钙素原、C反应蛋白、D-二聚体的水平变化及其对预后的诊断价值[J].医学综述,2020,26(15):3077-3081.[13]Guo S,Mao X,Liang M.The moderate predictive value of serial serum CRP and PCT levels for the prognosis of hospitalized community-acquired pneumonia[J].Respiratory Research,2018,19(1):193-202.[14]盛美玲,汪群智.慢性阻塞性肺疾病急性加重风险高危与低危患者呼吸道微生态系统差异分析[J].临床肺科杂志,2020,25(12):1787-1790.[15]Valenzi E,Tabib T,Papazoglou A,et al.Disparate Interferon Signaling and Shared Aberrant Basaloid Cells in Single-Cell Profiling of Idiopathic Pulmonary Fibrosis and Systemic Sclerosis-Associated Interstitial Lung Disease[J].Frontiers in Immunology,2021,12(4):595811.[16]温燕.特发性间质性肺炎患者下呼吸道菌群结构研究[D].北京:北京协和医学院,2016.[17]Fernández L,Cima-Cabal MD,Duarte AC,et al.Gram-Positive Pneumonia: Possibilities Offered by Phage Therapy[J].Antibiotics (Basel),2021,10(8):1000.[18]Quinton LJ,Walkey AJ,Mizgerd JP.Integrative Physiology of Pneumonia[J].Physiol Rev,2018,98(3):1417-1464.[19]Moreno-Gámez S,Hochberg ME,van Doorn GS.Quorum sensing as a mechanism to harness the wisdom of the crowds[J].Nature Communications,2023,14(1):3415-3434.[20]Weeks JR,Staples KJ,Spalluto CM,et al.The Role of Non-Typeable Haemophilus influenzae Biofilms in Chronic Obstructive Pulmonary Disease[J].Front Cell Infect Microbiol,2021,11(8):720742.

更新日期/Last Update: 1900-01-01