宏基因NGS技术在不明原因肺部感染诊断中的应用效能  

Application efficacy of metagenomic next generation sequencin in the diagnosis of unexplained pulmonary infection

作　　者：陈素婷[1] 杨剑[1] 董利民[1] 沈湘波[1] 宁瑶 CHEN Suting;YANG Jian;DONG Limin;SHEN Xiangbo;NING Yao(Department of Respiratory Medicine,Pingxiang People's Hospital,Jiangxi Province,Pingxiang 337000,China)

机构地区：[1]江西省萍乡市人民医院呼吸内科,江西萍乡337000

出　　处：《中国当代医药》2023年第15期41-44,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202212143)。

摘　　要：目的评价宏基因组二代测序(mNGS)技术在不明原因肺部感染诊断中的应用价值。方法选取2020年10月至2022年1月萍乡市人民医院收治的60例不明原因肺部感染患者为研究对象,根据是否合并基础疾病,分为有基础疾病组(n=33)和无基础疾病组(n=27)。所有患者均进行常规病原学检测、mNGS检测,以临床综合分析结果为标准,比较两种检测方法对不明原因肺部感染的检测效能。结果mNGS对真菌和病毒的检出率高于常规病原学检测,差异有统计学意义(P<0.05);在有基础疾病和无基础疾病的患者中,mNGS的检出阳性率均高于常规病原学检测,差异有统计学意义(P<0.05)。在感染种类数方面,mNGS对于2种和2种以上病原体的检出率高于常规病原学检测,对于1种病原体的检出率低于常规病原学检测,差异有统计学意义(P<0.05)。mNGS检测与临床诊断结果的符合率高于常规病原学检测,差异有统计学意义(P<0.05)。结论mNGS技术有助于判断不明原因肺部感染的病原体,相较于传统病原学检测,可明显提高病原体检出阳性率,具有较高的临床应用价值。Objective To evaluate the application value of metagenomic next generation sequencing(mNGS)in the diagnosis of unexplained pulmonary infection.Methods Sixty patients with unexplained pulmonary infection admitted to Pingxiang People's Hospital from October 2020 to January 2022 were selected as the research objects.According to whether they were complicated with underlying diseases,they were divided into group with underlying diseases(n=33)and group without underlying diseases(n=27).All patients were tested by conventional pathogen detection and mNGS detection.The results of clinical comprehensive analysis were taken as the standard to compare the detection efficiency of the two detection methods for unexplained pulmonary infection.Results The detection rate of fungi and viruses by mNGS was higher than that by conventional pathogen detection,the difference was statistically significant(P<0.05).In patients with and without underlying diseases,the positive rate of mNGS was higher than that of conventional etiological detection,the difference was statistically significant(P<0.05).In terms of the number of infection types,the detection rate of mNGS for 2 or more pathogens was higher than that of conventional pathogen detection,and the detection rate for 1 pathogen was lower than that of conventional pathogen detection,with statistically significant differences(P<0.05).The coincidence rate between mNGS detection and clinical diagnosis results was higher than that of conventional pathogen detection,and the difference was statistically significant(P<0.05).Conclusion mNGS is helpful to identify the pathogens of unexplained pulmonary infection.Compared with traditional pathogen detection,mNGS can significantly increase the positive rate of pathogens in physical examination,and has high clinical application value.

关 键 词：宏基因组二代测序 肺部感染 病原体 肺泡灌洗液 

分 类 号：R563.1[医药卫生—呼吸系统]