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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.
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