探讨支气管肺泡灌洗液tNGS检测对NTM-PD合并肺真菌病的早期诊断价值  

Exploring the Early Diagnostic Value of Balf tNGS Detection in Bronchoalveolar Lavage Fluid for NTM-PD Combined with Pulmonary Mycosis

作　　者：吴睿彦[1] 陈品儒[1] 谭耀驹[1] WU Ruiyan;CHEN Pinru;TAN Yaoju(District 1,Department of Severe Tuberculosis,Guangzhou Chest Hospital,Guangzhou,Guangdong 510095,China)

机构地区：[1]广东省广州市胸科医院重症结核科内一区,广东广州510095

出　　处：《中国医药指南》2025年第12期29-31,共3页Guide of China Medicine

基　　金：广州市科学技术局基础与应用基础研究项目(No.2023A03J0991);广州市科技计划项目(No.2023A03J0539)。

摘　　要：目的 探讨肺泡灌洗液病原靶向测序(Balf tNGS)早期诊断非结核分枝杆菌肺病(NTM-PD)合并肺真菌病的价值。方法 对本院67例影像学恶化的疑似NTM-PD合并肺真菌病患者采集BALF标本进行t NGS检测及真菌培养鉴定并结果对比评价。结果 Balf tNGS检测共有56例检出真菌,检出率83.58%,占比排前3位是烟曲霉菌、白色念珠菌、赛多孢菌属。t NGS与真菌培养鉴定两种方法在真菌的检测能力采用配比χ2检验方法进行对比,配对卡方检验结果 P<0.001,差异有意义,说明tNGS检测明显优于真菌培养鉴定。结论 Balf tNGS对NTM-PD影像学恶化的病例能够提供病原学诊断参考,对合并肺真菌病的早期诊断有积极的意义。Objective To investigate the value of pathogen targeted sequencing in alveolar lavage fluid(Balf tNGS)in early diagnosis of non-tuberculous mycobacterium lung disease(NTM-PD)complicated with pulmonary mycosis.Methods BALF samples were collected from 67 suspected NTM-PD patients with pulmonary mycosis who showed imaging deterioration at our hospital for tNGS detection and fungal culture identification,and the results were compared and evaluated.Results A total of 56 fungi were detected by Balf tNGS,the detection rate was 83.58%,and the top 3 fungi were Aspergillus fumigatus,Candida albicans and Sedospora.The results of paired Chi-square test(P<0.001)were significant,indicating that tNGS detection was significantly superior to fungal culture identification.Conclusions BALF tNGS can provide a pathogenic diagnostic reference for cases of NTM-PD imaging deterioration,and is of positive significance for early diagnosis of pulmonary mycosis.

关 键 词：非结核分枝杆菌肺病 肺真菌病 支气管肺泡灌洗液 

分 类 号：R519[医药卫生—内科学]