不同支气管镜采样方式联合二代测序在重症肺炎并机械通气患者病原诊断中的应用  

Application of Different Bronchoscopic Sampling Methods Combined with Metagenomic Next Generation Sequencing in the Pathogenic Diagnosis of Patients with Severe Pneumonia and Mechanical Ventilation

作　　者：李耀军[1] 李琳[1] LI Yaojun;LI Lin(Respiratory Intensive Care Unit,Luohe Central Hospital,Luohe 462000,China)

机构地区：[1]河南省漯河市中心医院呼吸与危重症科,河南漯河462000

出　　处：《临床医学工程》2023年第1期5-6,共2页Clinical Medicine & Engineering

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20191425)。

摘　　要：目的探讨不同支气管镜采样方式联合二代测序(mNGS)在重症肺炎并机械通气患者病原诊断中的应用价值。方法选取40例重症肺炎并机械通气患者,均采用保护性毛刷(PSB)、常规支气管肺泡灌洗(BALF)、支气管镜吸取(ETA)取样。比较不同采样方式联合mNGS与传统病原学检测对病原体的诊断效能。结果PSB、BALF与ETA采样后用mNGS检测病原体的阳性率、敏感度及特异度均高于传统病原学检测(P<0.05)。PSB+mNGS、BALF+mNGS、ETA+mNGS检测病原体的阳性率、敏感度、特异度及准确率比较差异无统计学意义(P>0.05)。结论与传统病原学检测相比,mNGS对病原体诊断效能更好,临床上应根据实际情况选择适当的采样方式进行mNGS检测,对重症肺炎患者的诊治具有重要的意义。Objective To explore the application value of different bronchoscopic sampling methods combined with metagenomic next generation sequencing(mNGS)in the etiological diagnosis of patients with severe pneumonia and mechanical ventilation.Methods 40 patients with severe pneumonia and mechanical ventilation were selected and sampled by protected specimen brush(PSB),bronchoalveolar lavage fluid(BALF)and endobronchial transbronchial aspiration(ETA).The diagnostic efficacy of different sampling methods combined with mNGS and traditional pathogen detection was compared.Results The positive rate,sensitivity and specificity of mNGS for pathogen detection after PSB,BALF and ETA sampling were higher than those of traditional pathogen detection(P<0.05).No statistical difference was found in the positive rate,sensitivity,specificity and accuracy of PSB+mNGS,BALF+mNGS and ETA+mNGS for detecting pathogens(P>0.05).Conclusions Compared with traditional pathogen detection,mNGS for pathogens has better diagnostic efficacy.In clinic,appropriate sampling methods should be selected according to the actual situation for mNGS detection,which is of great significance for the diagnosis and treatment of patients with severe pneumonia.

关 键 词：支气管镜采样方式 二代测序 重症肺炎 

分 类 号：R563.1[医药卫生—呼吸系统]