宏基因组二代测序技术在肾移植术后肺部感染中的应用价值  

Application of metagenomic next-generation sequencing in pulmonary infection after renal transplantation

作　　者：黄晨 叶雨[2] 罗海凤 聂峰 孙煦勇 秦科[2] 董建辉 李壮江 王洪良 Huang Chen;Ye Yu;Luo Haifeng;Nie Feng;Sun Xuyong;Qin Ke;Dong Jianhui;Li Zhuangjiang;Wang Hongliang(The 923rd Hospital of Joint Logistic Support Force of the People’s Liberation Army,Nanning 530021,Guangxi,China;The Second Affiliated Hospital of Guangxi Medical University,Nanning 530005,Guangxi,China)

机构地区：[1]中国人民解放军联勤保障部队第九二三医院,广西南宁530021 [2]广西医科大学第二附属医院,广西南宁530005

出　　处：《右江民族医学院学报》2022年第4期540-544,共5页Journal of Youjiang Medical University for Nationalities

基　　金：中国人体器官捐献专项研究课题(CODMP2017015)。

摘　　要：目的探讨宏基因组二代测序技术(mNGS)在肾移植术后肺部感染中的应用价值。方法回顾性分析2016年1月—2020年1月在中国人民解放军联勤保障部队第九二三医院器官移植中心因肺部感染入院治疗的肾移植受者58例的病史资料,分为传统病原体检测组(对照组)和mNGS组。通过比较两种不同的病原学检测方法的结果以及治疗前后各组的临床指标进行分析。结果mNGS组检测需要时间和阳性检出率明显高于对照组,差异有统计学意义(P<0.05);mNGS组抗菌药物使用强度明显少于对照组,差异有统计学意义(P<0.05);在治疗后CD4、CD4/CD8和谷丙转氨酶值明显少于对照组,差异有统计学意义(P<0.05);治疗后mNGS组患者的住院时间明显短于对照组(P<0.05)。两组的住院费用、治疗后两组CD4、CD8,血糖值3项指标间的差异无统计学意义(P>0.05)。结论与传统检测方法相比,mNGS可明显提高病原菌检出率和缩短检测时间,在肾移植术后肺部感染的治疗中应用价值高,值得在临床上推广应用。Objective To explore the application value of metagenomic next-generation sequencing(mNGS)in pulmonary infection after renal transplantation.Methods This study carried out a retrospective analysis of the medical history of 58 kidney transplant recipients who were hospitalized for pulmonary infection in the Organ Transplant Center of The 923rd Hospital of the Joint Logistic Support Force of the Chinese Peoples’Liberation Army from January 2016 to January 2020.They were divided into a conventional pathogen detection group(control group)and a mNGS group.It moved on to compare and analyze the results of the above two pathogenic detection methods and the clinical indicators of each group before and after treatment.Results The mNGS group needed shorter detection time and had higher positive detection rate than the control group,and the differences were statistically significant(P<0.05).The mNGS group used less antibiotics than the control group,and the difference was statistically significant(P<0.05).After treatment,the values of CD4,CD4/CD8 and glutamic-pyruvic transaminase in the mNGS group were significantly lower than those in the control group,indicating significant statistical differences(P<0.05).After treatment,the length of hospitalization in the mNGS group was significantly shorter than that in the control group(P<0.05).There were no significant differences in hospitalization expenses,CD4 level,CD8 level and blood glucose between two groups after treatment(P>0.05).Conclusion Compared with conventional detection methods,mNGS can significantly improve the detection rate of pathogenic bacteria and shorten the detection time.It is of high application value in the treatment of pulmonary infection after kidney transplantation and worthy of clinical application.

关 键 词：肾移植 肺部感染 宏基因组学 

分 类 号：R617[医药卫生—外科学] R619.3[医药卫生—临床医学]