宏基因组二代测序对结缔组织病并发肺部感染的病原学诊断价值研究  

Value of Metagenomic Next-generation Sequencing in the Pathogenic Diagnosis of Connective Tissue Disease Combined with Pulmonary Infection

作　　者：孙莉[1] 马艳[1] 厉小梅 王俐 SUN Li;MA Yan;LI Xiaomei;WANG Li(Department of Rheumatology and Immunology,the First Affiliated Hospital of University of Science and Technology of China,Hefei 230000,China)

机构地区：[1]中国科学技术大学附属第一医院风湿免疫科,合肥230000

出　　处：《现代检验医学杂志》2023年第5期1-4,52,共5页Journal of Modern Laboratory Medicine

基　　金：国家自然科学基金项目(项目编号:81871271):组织原位记忆T细胞在干燥综合征中的作用及其分子调控机制的研究。

摘　　要：目的 研究宏基因组二代测序(metagenomic next-generation sequencing,mNGS)对结缔组织病并发肺部感染的病原学诊断价值。方法 选取2019年5月~2022年5月中国科学技术大学附属第一医院风湿免疫科诊治的结缔组织病并发肺部感染患者73例,分析mNGS与传统病原学检测的检出率、检测时间、病原体种类、各类病原体检出率。将患者分为重症肺炎组(n=44)和轻症肺炎组(n=29),比较两组病原体检出率及分布情况。结果 mNGS病原体检出率(83.56%)、病毒(60.27%)、真菌(52.05%)和2种及以上病原体(53.42%)检出率均高于传统检测(57.53%,17.81%,34.25%,13.70%),检测时间[25(5)h]少于传统病原学检测[(120(48)h)],差异均有统计学意义(χ^(2)=10.452,23.077,4.966,22.400,Z=-10.155,P=0.001,0.001,0.026,<0.001,<0.001)。重症肺炎组mNGS(95.45%)和传统病原学(68.18%)检出率均高于轻症肺炎组(65.52%,41.38%),差异均有统计学意义(χ^(2)=11.608,5.139;P=0.001,0.023)。结论 结缔组织病并发肺部感染患者中,mNGS检测时间更短,病原体检出率高于传统检测,其有助于快速全面地检测和鉴定病原体,明确感染诊断和指导临床治疗。Objective To investigate the value of metagenomic next-generation sequencing(mNGS)in the etiological diagnosis of connective tissue disease complicated with pulmonary infection.Methods A total of 73 patients with connective tissue disease combined with pulmonary infection diagnosed and treated by the Rheumatology Department of the First Affiliated Hospital of University of Science and Technology of China from May 2019 to May 2022 were selected to analyze the detection rate,detection time,pathogen type and detection rate of various pathogens between mNGS and traditional etiological detection.The patients were divided into severe pneumonia group(n=44)and mild pneumonia group(n=29),and the detection rate and distribution of pathogens in the two groups were compared.Results The detection rate of mNGS pathogens(83.56%),viruses(60.27%),fungi(52.05%)and 2 or more pathogens(53.42%)were higher than traditional detection(57.53%,17.81%,34.25%,13.70%),and the detection time[25(5)h]was shorter than traditional detection[(120(48)h)],and the differences were statistically significant(χ^(2)=10.452,23.077,4.966,22.400,Z=-10.155,P=0.001,0.001,0.026,<0.001,<0.001).The detection rates of mNGS(95.45%)and traditional etiology(68.18%)in severe pneumonia group were higher than those in mild pneumonia group(65.52%,41.38%),and the differences were statistically significant(χ^(2)=11.608,5.139,P=0.001,0.023).Conclusion In patients with connective tissue disease complicated with pulmonary infection,the detection time of mNGS was shorter,and the pathogen detection rate was higher than that of traditional detection,which is helpful for rapid and comprehensive detection and identification of pathogens,clear infection diagnosis,and guide clinical treatment.

关 键 词：宏基因组二代测序 病原学 肺部感染 结缔组织病 

分 类 号：Q781[生物学—分子生物学] R563.1[医药卫生—呼吸系统]