[1]汪 艳,李晨辉,刘盛国,等.肺泡灌洗液高通量测序在肺部感染的诊断价值[J].医学信息,2020,33(23):160-163.[doi:10.3969/j.issn.1006-1959.2020.23.047]
　WANG Yan,LI Chen-hui,LIU Sheng-guo,et al.Diagnostic Value of High-throughput Sequencing of Alveolar Lavage Fluid in Pulmonary Infection[J].Medical Information,2020,33(23):160-163.[doi:10.3969/j.issn.1006-1959.2020.23.047]
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肺泡灌洗液高通量测序在肺部感染的诊断价值()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年23期
页码:
160-163
栏目:
诊疗技术
出版日期:
2020-12-01

文章信息/Info

Title:
Diagnostic Value of High-throughput Sequencing of Alveolar Lavage Fluid in Pulmonary Infection
文章编号:
1006-1959（2020）23-0160-04
作者:
汪 艳; 李晨辉; 刘盛国; 等
（深圳市人民医院呼吸疾病研究所呼吸与危重症医学科/南方科技大学附属第一医院，广东 深圳 518020）
Author(s):
WANG Yan; LI Chen-hui; LIU Sheng-guo; et al
(Department of Respiratory and Critical Care Medicine,Institute of Respiratory Diseases,Shenzhen People’s Hospital/ the First Affiliated Hospital of Southern University of Science and Technology,Shenzhen 518020,Guangdong,China)
关键词:
肺泡灌洗液; 高通量测序; 肺部感染; 病原学
Keywords:
Alveolar lavage fluid; High-throughput sequencing; Pulmonary infection; Etiology
分类号:
R446.5
DOI:
10.3969/j.issn.1006-1959.2020.23.047
文献标志码:
A
摘要:
目的 探讨肺泡灌洗液高通量测序在肺部感染的病原学诊断价值。方法 收集2019年2月~2020年3月深圳市人民医院呼吸与危重症医学科送检的37例肺部感染患者的检测结果及临床资料，分析患者的一般临床资料及高通量测序在肺部感染性疾病中的检测结果及临床转归情况。结果 37例患者中男性多于女性，主要集中于＜65岁年龄段，无吸烟史患者居多，多合并基础疾病，以急性病程为主，CT表现为单肺病变和双肺病变。肺泡灌洗液标本中高通量病原体阳性率高于常规培养（64.86% vs 24.32%），差异有统计学意义（P＜0.05）；两者病原体报告时间比较，差异无统计学意义（P＞0.05）。高通量测序检出单一病原菌感染19例，混合感染5例，与微生物病原体一致且考虑致病菌8例，与常规微生物培养相比，其灵敏度为88.89%，特异度为42.86%。13例根据高通量测序结果调整了治疗方案，临床获益。结论 肺泡灌洗液高通量测序对肺部感染的病原体检测较为敏感、诊断相对准确，可提高肺部感染的病原体检测阳性率，尤其是对于混合及少见、罕见菌感染，对于临床微生物标本培养阴性的人群针对性地使用抗生素有一定的参考价值。
Abstract:
Objective To investigate the etiological diagnostic value of high throughput sequencing of alveolar lavage fluid in pulmonary infection.Methods Collect the test results and clinical data of 37 patients with pulmonary infection sent by the Department of Respiratory and Critical Care Medicine of Shenzhen People’s Hospital from February 2019 to March 2020,analyze the general clinical data of patients and the detection results and clinical outcomes of high-throughput sequencing in pulmonary infectious diseases.Results Among the 37 patients, there were more males than females, mainly in the age group <65 years old. The majority of patients had no history of smoking, and most of them had underlying diseases, mainly with acute course. CT showed single lung disease and double lung disease. The positive rate of high-throughput pathogens in alveolar lavage fluid specimens was higher than that in conventional culture (64.86% vs 24.32%), the difference was statistically significant (P<0.05); the comparison of the pathogen reporting time between the two was not statistically significant (P>0.05). High-throughput sequencing detected 19 cases of single pathogen infection and 5 cases of mixed infection, which were consistent with microbial pathogens and 8 cases of pathogenic bacteria were considered. Compared with conventional microbial culture, the sensitivity was 88.89% and the specificity was 42.86%. The treatment plan was adjusted in 13 cases based on the results of high-throughput sequencing, and the clinical benefit was achieved.Conclusion High-throughput sequencing of alveolar lavage fluid is more sensitive and accurate for the detection of pathogens in pulmonary infection, which can improve the positive rate of pathogen detection in pulmonary infection, especially for mixed and rare and rare bacterial infections. It has certain reference value for the population with negative culture of clinical microbial specimens to use antibiotics.

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更新日期/Last Update: 1900-01-01