高通量二代基因测序技术在器官移植术后肺部感染病原诊断的应用观察  

Application of high-throughput second-generation gene sequencing in the diagnosis of pulmonary infection after organ transplantation

作　　者：陆瀚澜 隋明星 赵闻雨 陈瑞 付嘉钊 曾力 朱有华 张雷 Lu Hanlan;Sui Mingring;Zhao Wenyu;Chen Rui;Fu Jiazhao;Zeng Li;Zhu Youhuca;Zhang Lei(Deparment of Organ Transplantation,Affiliated Changhai Hospital,Nary Military Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学附属长海医院器官移植中心,上海200433

出　　处：《中华器官移植杂志》2020年第7期388-392,共5页Chinese Journal of Organ Transplantation

摘　　要：目的探讨基于宏基因组学的高通量二代基因测序技术在器官移植术后肺部感染诊断中的应用。方法回顾性分析2016年6月至2020年1月期间,海军军医大学附属长海医院器官移植中心因肺部感染入院治疗的肾移植和肝移植受者共34例的病史资料,按时间段2016年6月至2018年12月为传统病原检测组,共20例,均采用传统病原检测方法。2019年1月至2020年1月为二代基因测序组,共14例,均采用高通量二代基因测序技术。统计分析两组间病原学检出率.灵敏度和特异度、检测结果回报时间、住院时间、28 d病死率等指标。结果两组间临床基本资料(年龄、性别、抗体诱导方式、免疫抑制剂使用等)差异无统计学意义,二代基因测序组的病原学阳性检出率高于传统检测组,灵敏度高于传统检测组,特异度差异无统计学意义。二代基因检测组检测结果回报耗时明显短于传统检测组,差异有统计学意义。二代基因测序组住院时间.28 d病死率低于传统检测组,差异有统计学意义。结论高通量二代基因测序技术可提高器官移植术后肺部感染的病原检出率,为疾病的治疗提供"精而准"的指向,是传统诊断方法的有益补充。Objective To explore the application of high-throughput second-generation gene sequencing technology based upon metagenomics in the diagnosis of pulmonary infection after organ transplantation.Methods From June 2016 to January 2020,clinical records were retrospectively reviewed for 34 renal and liver transplant recipients hospitalized for pulmonary infection.From June 2016 to December 2018,they were assigned as group A(n=20)of traditional pathogen detections.From January 2019 to January 2020,14 cases in group B were sequenced by high-throughput second-generation technology.The detection rate,sensitivity and specificity,the return time of detection results,the average length of stay and the mortality of 28 days between two groups were analyzed.Results No significant inter-group difference existed in clinical data(age,gender,antibody induction method,immunosuppressant use,etc.).As compared with group A,the positive detection rate of etiology and the the sensitivity were higher in group B and the differences in specificity were statistically insignificant.The return time of test results in group B was significantly shorter than that in group A.And the difference was statistically significant.The average hospitalization stay and 28-day mortality of group B were lower than those of group A.And the differences were statistically significant.Conclusions High-throughput second-generation gene sequencing technology can improve the detection rate of pulmonary infection after organ transplantation.Providing a"precise and accurate"direction for disease treatment,it is a useful supplement to traditional diagnostic methods.

关 键 词：器官移植 宏基因组学 感染 

分 类 号：R617[医药卫生—外科学] R563.1[医药卫生—临床医学]