外周血宏基因组二代测序技术对恶性血液病合并发热患者的诊断价值  

Diagnostic value of peripheral blood metagenomic next-generation sequencing technology in patients with malignant hematologic diseases complicated with fever

作　　者：谢颖[1] 郑志海[1] 曲双[1] 廖丽昇[1] 陈碧云[1] XIE Ying;ZHENG Zhihai;QU Shuang;LIAO Lisheng;CHEN Bi yun(Department of Hematology,Fujian Provincial Hospital,Shengli Clinical College of Fujian Mdical University,FuzhouUniversity Affiliated Provincial Hospital,Fuzhou,Fujian 350001,China)

机构地区：[1]福建医科大学省立临床医学院,福建省立医院血液科,福州大学附属省立医院,福州350001

出　　处：《福建医药杂志》2024年第7期12-15,共4页Fujian Medical Journal

摘　　要：目的探讨外周血宏基因组二代测序(mNGS)技术对恶性血液病合并发热患者的诊断价值.方法回顾性分析2021年6月至2023年6月在我院住院治疗的恶性血液病合并发热的患者23份外周血mNGS结果,与传统血培养检测结果进行比较,分析其病原谱特征及抗感染的疗效.结果23例患者中,通过外周血mNGS技术检出9例病毒感染、4例细菌感染、2例真菌感染、3例病毒和细菌混合型感染、1例病毒和真菌混合型感染.传统外周血培养仅检出3例细菌感染,主要为肺炎克雷伯菌及鲍曼不动杆菌,未检出真菌及病毒.外周血mNGS阳性检出率明显高于传统血培养(82.6%vs.13.0%,P<0.05).根据外周血mNGS检测结果进行针对性抗感染治疗,有效率明显优于传统经验性抗感染治疗(73.6%vs.25.0%,P<0.05).结论外周血mNGS技术在恶性血液病合并发热患者的病原学诊断上较传统血培养具有更高的价值,有助于提高临床抗感染的疗效.Objective To investigate the diagnostic value of peripheral blood metagcnomic ncxt-gencration sequencing(mNGS)in patients with malignant hematologic discases complicated with fever.MethodsTwenty-three peripheral bloodmNGS results from patients with malignant hematologic discases complicated with fever who were hospitalized in Fujian Provin-cial Hospital from June 2021 to June 2023 were restrospectively analyzed,and compared with traditional blood culture tests.Thecharacteristics of the pathogcnic spectrum and the efficacy of antiinfection were analyzed.Results Among the 23 patients detected by peripheral blood mNGS technology,9 casces were diagnosed of viral infection,4 cases of bacterial infection,2 cases of fungal infection,3 cases of mixed viral and bacterial infection,and 1 case of mixed viral and fungal infection.Only three cases detected in traditional peripheral blood culture were diagnosed of bacterial infection,mainly Klebsiella pncumoniac and Acinctobacter baumanmii,but no fungi and viruses were detected.The positive detection rate of mNGS in peripheral blood was significantly higher than that in traditional blood culture(82.6%vs.13.0%,P<0.05).The effective rate of targetcd antiinfectivetherapy based on the results of peripheral blood mNGS was significantly higher than that of traditional empirical anti-infectivetherapy(73.6.%vs.25.0%,P<0.05).Conclusion Compared with traditional blood culture,peripheral blood mNGS technology has higher positive detcction rate than traditional blood culture in the ctiological diagnosis of paticnts with malignant hemato-logic discases complicated with fever,which is helpful to improvc the clinical anti-infection efficacy.

关 键 词：恶性血液病 外周血宏基因组二代测序技术 发热 

分 类 号：R552[医药卫生—血液循环系统疾病]