人偏肺病毒靶向高通量测序在儿童急性下呼吸道感染中的临床应用  

Clinical Application of Human Metapneumovirus Targeted Next-Generation Sequencing with Acute Lower Respiratory Tract Infection in Children

作　　者：胡冰 王柳 刘俊[1,2] 黄先红 温雪风[1] 张艳清 HU Bing;WANG Liu;LIU Jun;HUANG Xianhong;WEN Xuefeng;ZHANG Yanqing(Department of Pediatrics,Yichun City People s Hospital,Yichun 336000,China;Jiangxi Medical College,Nanchang University,Nanchang 330000,China)

机构地区：[1]宜春市人民医院儿科,宜春336000 [2]南昌大学江西医学院,南昌330000

出　　处：《福建医科大学学报》2025年第1期57-61,共5页Journal of Fujian Medical University

基　　金：宜春市卫健委指导性科技计划项目(JXYC2024KSA045)。

摘　　要：目的探讨人偏肺病毒(HMPV)靶向高通量测序(tNGS)在儿童急性下呼吸道感染(ALRTI)诊断治疗中的临床应用价值。方法收集2023年6月-2024年10月宜春市人民医院儿科收治的140例HMPV感染的ALRTI患儿的临床资料,男童78例(55.7%),女童62例(44.3%),年龄2个月~3岁,均经tNGS检测确诊。按临床表现将患儿分为轻、中、重症状组,3组分别为49例(35.0%)、48例(34.3%)、43例(30.7%)。对3组患儿进行潮气肺功能检查,分析HMPV检测序列数与ALRTI病情严重程度及肺功能结果的相关性。结果重症状组的HMPV序列数较轻、中症状组升高,差别均有统计学意义(P<0.05);与轻、中症状组比较,重症状组的达峰时间比、达峰容积比以及25%、50%、75%的潮气量呼气流量均降低,差别均有统计学意义(P<0.05);3组间单位体质量潮气量比较,差别无统计学意义(P>0.05);重症状组的HMPV序列数与达峰时间比、达峰容积比均呈负相关改变(r=-0.237、-0.017),但差别无统计学意义(P>0.05)。结论HMPV的tNGS序列数与病毒载量意义相同,高序列数的HMPV更易引发儿童下呼吸道重症感染及阻塞性肺功能损伤、小气道功能受损,积极采取有效措施可改善预后。Objective To investigate the clinical application value of human metapneumovirus(HMPV)targeted next-generation sequencing(tNGS)in the diagnosis and treatment of acute lower respiratory tract infection(ALRTI)in children.Methods The clinical data of 140 children with ALRTI detected as HMPV infection by tNGS admitted to the Department of Pediatrics of Yichun City People s Hospital from June 2023 to October 2024 were collected.The age of the children ranged from 2 months to 3 years old,with 78(55.7%)boys and 62(44.3%)girls.According to clinical manifestations,they were divided into mild,moderate and severe symptom groups,with 49 cases(35.0%),48 cases(34.3%)and 43 cases(30.7%)in the 3 groups respectively.Tidal breathing lung function analysis were performed on the children in the 3 groups was examined to analyze the correlation between the number of HMPV detection sequences and the severity of ALRTI and pulmonary function results.Results The HMPV sequence array was higher in severe symptom group than in moderate and mild symptom groups,and the differences were statistically significant(P<0.05);compared with mild and moderate symptom groups,ratio of time to peak tidal expiratory flow to total expiratory time,ratio of volume at peak tidal expiratory flow to expiratory tidal volume,tidal expiratory flow at 25%,50%,75%tidal volume in severe symptom group were lower,and the differences were statistically significant(P<0.05);there was no statistically significant difference compared with tidal volume per kilogram in the 3 groups(P>0.05);the number of HMPV sequences in the severe symptom group was negatively correlated with ratio of time to peak tidal expiratory flow to total expiratory time and ratio of volume at peak tidal expiratory flow to expiratory tidal volume(r=-0.237,-0.017),but the differences were not statistically significant(P>0.05).Conclusion The tNGS sequence number of HMPV had the same significance as viral load,and high sequence number was more likely to cause severe lower respiratory tract infection,obstruc

关 键 词：下呼吸道感染 人偏肺病毒 靶向高通量测序 均一化序列数 儿童 

分 类 号：R725.6[医药卫生—儿科]