宏基因二代测序技术在重症肺炎病原体检测及治疗方案制定中的应用  

Application of metagenomics next-generation sequencing in diagnosis and treatment of severe pneumonia pathogens

作　　者：张安兵[1] 袁小玲[1] 夏秀琼[1] 吕燕华[1] 张丹丹 梁剑平[1] ZHANG Anbing;YUAN Xiaoling;XIA Xiuqiong;LYU Yanhua;ZHANG Dandan;LIANG Jianping(Department of Respiratory and Critical Care Medicine,Zhongshan People’s Hospital,Zhongshan 528400,China)

机构地区：[1]中山市人民医院呼吸与危重症医学科,广东中山528400

出　　处：《山东医药》2022年第3期16-19,共4页Shandong Medical Journal

基　　金：广东省医学科学技术研究基金项目(C2019032);中山市医学科研项目(2021J096)。

摘　　要：目的观察宏基因二代测序技术(mNGS)在重症肺炎病原体检测及治疗方案制定中的应用效果。方法112例重症肺炎患者随机分为实验组和对照组,患者均行肺泡灌洗术;实验组灌洗液送mNGS检测,对照组灌洗液行一般细菌、真菌培养;两组均根据病原体检测结果调整抗感染方案。比较两组病原体检出率、抗生素使用时间、机械通气时间、住院日、住院费用、临床疗效、病死率。结果实验组病原体检出率高于对照组(χ;=23.59,P<0.05);实验组抗生素使用时间、机械通气时间、住院日、住院费用少于对照组(P均<0.05);实验组临床疗效高于对照组(χ;=3.895,P=0.048);实验组病死率低于对照组,但差异无统计学意义(χ;=1.037,P=0.308)。结论mNGS可提高重症肺炎病原体的检出率;对重症肺炎患者,根据mNGS的病原体检测结果调整制定治疗方案,可缩短抗生素使用时间、机械通气时间、住院时间,减少住院费用,提高治疗效果。Objective agnosis and treatment of severe pneumonia pathogens.Methods ed into the experimental group and control group. All patients underwent alveolar lavage;the lavage solution of the control group underwent general bacterial and fungal culture,and the lavage solution of the experimental group underwent mNGS detection;the anti-infection regimen was adjusted according to the pathogen test results in both groups. The pathogen physical examination rate,antibiotic use time,mechanical ventilation time,curative effect,hospitalization days,hospitalization expenses and mortality were compared between the two groups.Results the experimental group was significantly higher than that in the control group(χ;=23. 59,P<0. 05);the clinical efficacy of the experimental group was higher than that of the control group(χ;=3. 895,P=0. 048);the antibiotic use time,mechanical ventilation time,average hospitalization days,and average hospitalization expenses in the experimental group were lower than those in the control group(all P<0. 05). The mortality of the experimental group was lower than that of the control group,but there was no statistically significant difference(χ;=1. 037,P=0. 308).Conclusion in the severe pneumonia can significantly improve the positive rate of pathogen detection,improve the treatment effect,and reduce the use time of antibiotics,mechanical ventilation time,hospitalization time and hospitalization cost.

关 键 词：宏基因二代测序 病原体 肺炎病原体 病原体诊断 肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]