外周血宏基因组二代测序诊断侵袭性肺曲霉病的运用  

Application of peripheral blood metagenomic next generation sequencing in the diagnosis of invasive pulmonary aspergillosis

作　　者：丁志荣[1] 曾海文[1] 林天来[1] 陈伟文[1] DING Zhirong;ZENG Haiwen;LIN Tianlai;CHEN Weiwen(Department of Critical Care,Quanzhou First Hospital Affiliated to Fujian Medical University,quanzhou 362000,China)

机构地区：[1]福建医科大学附属泉州第一医院重症医学科,泉州362000

出　　处：《中国真菌学杂志》2023年第5期411-415,422,共6页Chinese Journal of Mycology

基　　金：泉州市医疗卫生领域科技计划项目(2023NS037)。

摘　　要：目的通过外周血宏基因组二代测序识别侵袭性肺曲霉病,证明其在侵袭性肺曲霉病临床诊断中的重要作用。方法报道福建医科大学附属泉州第一医院重症医学科收住的3例通过外周血宏基因二代测序识别诊断的侵袭性肺曲霉病病例,分析总结外周血宏基因二代测序在诊断侵袭性肺曲霉病的可行性。结果在3例病例中,病例1无基础疾病,病例2合并慢性阻塞性肺病,病例3存在T淋巴母细胞性淋巴瘤/白血病并化疗后粒细胞缺乏。通过支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF)培养、痰培养、外周血宏基因二代测序、血G试验、GM试验等方法,诊断为侵袭性肺曲霉病。结论通过外周血宏基因二代测序检测曲霉cfDNA可用于侵袭性肺曲霉病的诊断,是一种快速、简单的诊断方法。Objective Metagenomic next generation sequencing was used to identify invasive pulmonary aspergillosis,which proved its important role in the clinical diagnosis of invasive pulmonary aspergillosis.Methods Three cases of invasive pulmonary aspergillosis were identified and diagnosed by peripheral blood metagenomic next generation sequencing in the Department of critical care medicine.The feasibility of peripheral blood metagenomic next generation sequencing in the diagnosis of invasive pulmonary aspergillosis was analyzed and summarized.Results Of the three cases,case 1 had no underlying disease,case 2 had chronic obstructive pulmonary disease,and case 3 had T-lymphoblastic lymphoma/leukemia with agranulocytosis after chemotherapy.Invasive pulmonary aspergillosis was diagnosed by bronchoalveolar lavage fluid(BALF)culture,sputum culture,peripheral blood metagenomic next generation sequencing,blood G test,GM test and other methods.Conclusions Detection of Aspergillus cfDNA by peripheral blood metagenomic next generation sequencing,which is a rapid,and simple diagnostic method,can be used for the diagnosis of invasive pulmonary aspergillosis.

关 键 词：侵袭性肺曲霉病 诊断 外周血 宏基因组二代测序 

分 类 号：R519.8[医药卫生—内科学]