肺泡灌洗液mNGS技术在痰菌阴性肺结核患者诊断中的应用  

Application of mNGS technology in the diagnosis of sputum negative pulmonary tuberculosis patients using bronchoalveolar lavage fluid

作　　者：龚春林 Gong Chun-lin(Department of Infectious Diseases,Nankang District First People's Hospital,Ganzhou 341400,Jiangxi,China)

机构地区：[1]南康区第一人民医院感染科,江西赣州341400

出　　处：《四川生理科学杂志》2024年第5期1019-1021,1058,共4页Sichuan Journal of Physiological Sciences

摘　　要：目的:分析肺泡灌洗液宏基因组二代测序(Metagenomic next-generation sequencing,mNGS)技术在痰菌阴性肺结核患者诊断中的应用价值。方法:选取2020年1月至2023年12月我院收治的60例痰菌阴性疑似肺结核患者作为研究对象,所有患者均采集肺泡灌洗液标本,并行抗酸染色及mNGS技术检查,以临床诊断结果为金标准,分析两种检查手段的诊断效能。结果:临床诊断结果显示,60例痰菌阴性疑似肺结核患者中,48例痰菌阴性肺结核患者,12例非肺结核患者;所有患者中被确诊为痰菌阴性肺结核患者48例,以男性(60.42%)、年龄<50岁(68.75%)、有吸烟史(52.08%)、病灶累及右肺上叶(47.92%)、形态为肺叶/段实变(72.92%)等为主;肺泡灌洗液mNGS技术诊断痰菌阴性肺结核的准确度、敏感度分别为90.00%、87.50%,高于抗酸染色诊断的73.33%、68.75%(P<0.05)。结论:肺泡灌洗液mNGS技术对痰菌阴性肺结核具有较高的诊断效能,相较于抗酸染色能提高诊断的准确度及敏感度。Objective:To analyze the application value of metagenomic next-generation sequencing(mNGS)technology in the diagnosis of sputum negative pulmonary tuberculosis patients using bronchoalveolar lavage fluid.Methods:Sixty sputum negative suspected pulmonary tuberculosis patients were selected from our hospital from January 2020 to December 2023.All patients collected alveolar lavage fluid samples and underwent acid fast staining and mNGS technology examination.The clinical diagnostic results were used as the gold standard to analyze the diagnostic efficacy of the two examination methods.Results:Clinical diagnosis showed that among 60 suspected tuberculosis patients with sputum negative results,48 were sputum negative tuberculosis patients and 12 were non tuberculosis patients;Among all patients,48 were diagnosed with sputum negative pulmonary tuberculosis,mainly male(60.42%),age<50 years old(68.75%),smoking history(52.08%),involvement of the right upper lobe of the lung(47.92%),and consolidation of the lung lobe/segment(72.92%);The accuracy and sensitivity of mNGS technology in diagnosing sputum negative pulmonary tuberculosis using bronchoalveolar lavage fluid were 90.00%and 87.50%,respectively,which were higher than those of 73.33%and 68.75%using acid fast staining(P<0.05).Conclusion:The mNGS technique of alveolar lavage fluid has a high diagnostic efficacy for sputum negative pulmonary tuberculosis,and can improve the accuracy and sensitivity of diagnosis compared to acid fast staining.

关 键 词：痰菌阴性肺结核 宏基因组二代测序技术 抗酸染色 肺泡灌洗液 诊断效能 

分 类 号：R521[医药卫生—内科学]