高通量测序在脓毒症患者病原学诊断中的应用价值及测序结果的影响因素  被引量:2

Application value of high-throughput sequencing in the etiology diagnosis of patients with sepsis and influencing factors for sequencing results

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作  者:陈维觉 蒋玲玉[2] 钟永泷[3] 宁中心 韩林[2] CHEN Wei-jue;JIANG Ling-yu;ZHONG Yong-long;NING Zhong-xin;HAN Lin(Intensive Care Unit,GuiPing People's Hospital,Guiping 537200,Guangxi,China;Intensive Care Unit,the People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,Guangxi,China;Department of Thoracic Surgery,the People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,Guangxi,China)

机构地区:[1]广西桂平市人民医院重症医学科,广西桂平市537200 [2]广西壮族自治区人民医院重症医学科,广西南宁市530021 [3]广西壮族自治区人民医院胸外科,广西南宁市530021

出  处:《广西医学》2022年第17期1961-1965,共5页Guangxi Medical Journal

基  金:广西南宁市青秀区科技计划项目(2020032)。

摘  要:目的评估高通量测序在脓毒症患者病原学诊断中的应用价值,并分析影响测序结果的因素。方法纳入59例脓毒症患者,收集其病原体检测结果,比较高通量测序和血培养的检测结果。比较高通量测序阳性和阴性患者的临床资料,并采用Logistic回归模型分析影响高通量测序结果的因素。结果高通量测序检出30种病原菌,血培养仅检出4种细菌和2种真菌。高通量测序检出阳性率为50.8%(30/59),高于血培养的13.6%(8/59)(P<0.05)。与高通量测序阴性的患者相比,高通量测序阳性的患者中,女性比例更高,使用血管活性药物的例数更少(均P<0.05)。中性粒细胞比例是高通量测序阳性的影响因素(P<0.05),其中中性粒细胞比例升高时高通量测序阳性的概率增加。结论相比于传统血培养,高通量测序更有助于有效识别脓毒症患者的致病菌。当患者机体对感染存在一定反应、循环功能稳定或组织灌注较好时,阳性检出率较高。Objective To evaluate the application value of high-throughput sequencing in the etiology diagnosis of patients with sepsis,and to analyze the factors affecting the sequencing results.Methods A total of 59 patients with sepsis were enrolled,and their results of pathogen detection were collected.The detection results between high-throughput sequencing and blood culture were compared.The clinical data between patients with positive and negative high-throughput sequencing were compared.The Logistic regression model was performed to analyze the factors affecting the results of high-throughput sequencing.Results Totally 30 kinds of pathogens were detected by high-throughput sequencing,whereas only 4 kinds of bacteria and 2 kinds of fungi were detected by blood culture.The positive rate detected by high-throughput sequencing was 50.8%(30/59),which was higher than that by blood culture(13.6%,8/59;P<0.05).Compared with the patients with negative high-throughput sequencing,among patients with positive high-throughput sequencing,the proportion of females was higher,and fewer cases used vasoactive medicine(all P<0.05).The proportion of neutrophils was an influencing factor for positive high-throughput sequencing(P<0.05),among which when the proportion of neutrophils was increased,the probability of positive high-throughput sequencing was increased.Conclusion Compared with conventional blood culture,high-throughput sequencing is helpful to effectively recognize pathogens in patients with sepsis.When the patient's body has a certain response to infection,circulatory function is stable or tissue perfusion is good,the positive detection rate is higher.

关 键 词:脓毒症 高通量测序 病原学诊断 影响因素 

分 类 号:R631[医药卫生—外科学]

 

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