多重PCR技术在急诊肺部感染患者病原学诊断中的应用价值  

Application Value of Multiple PCR in Etiological Diagnosis of Emergency Pulmonary Infection Patients

作　　者：郑伟 杨蜀罡 林鑫 张勇[1] 夏峻巍[1] 邓澎[2] Zheng Wei;Yang Shugang;Lin Xin(Department of Emergency,the First People's Hospital of Longquanyi,Chengdu,Sichuan 610000,China)

机构地区：[1]成都市龙泉驿区第一人民医院急诊科,四川成都610000 [2]四川大学华西医院急诊科,四川成都610000

出　　处：《四川医学》2025年第4期391-396,共6页Sichuan Medical Journal

摘　　要：目的本研究旨在评估多重PCR技术(24种病原体进行联合检测)在急诊肺部感染患者病原学诊断中的应用价值,对比多重PCR技术、痰培养两种检测方式的检测结果,为急诊科肺部感染患者的早期准确用药提供依据。方法本研究是一项前瞻性研究,入选2024年1月至7月在成都市龙泉驿区第一人民医院急诊科就诊的肺部感染患者,收集该类患者入院时的第一次痰培养、多重PCR检测结果,同时进行对比分析。结果共133例患者纳入本研究,多重PCR技术在混合病原体感染检出率方面较痰培养更高,且阴性检出率更低、检测用时更少[(4.29±1.01)h vs.(54.56±20.31)h,t=-28.51,P<0.01]。在一致性检测方面两种检测方式则表现出中等强度的一致性(Kappa=0.33,P<0.01),同时以痰培养为标准,多重PCR技术在检测病原体方面敏感度较高,敏感度为85.71%。结论多重PCR技术与痰培养在病原体检测方面存在中等强度的一致性,且多重PCR技术敏感度较高、检测用时更短,临床医生根据多重PCR技术检测结果调整抗菌药物,减少了不必要的抗菌药物使用时间。Objective This study aimed to evaluate the application value of multiplex PCR(for the simultaneous detection of 24 pathogens)in the etiological diagnosis of emergency patients with pulmonary infection.By comparing the results of multiplex PCR and sputum culture,we sought to provide a basis for early and accurate antibiotic treatment in emergency department patients with pulmonary infections.Methods This prospective,study enrolled patients with pulmonary infections admitted to the Emergency Department of The First People s Hospital of Longquanyi District between January 2024 and July 2024.The initial sputum culture and multiplex PCR results were collected and analyzed for comparison.Results A total of 133 patients were enrolled in this study.The detection rate of mixed pathogen infection by multiple PCR was higher than that of sputum culture,and the negative detection rate was lower and the detection time was less[(4.29±1.01)h vs.(54.56±20.31)h,t=-28.51,P<0.01].In terms of consistency test,the two methods showed moderate consistency(Kappa=0.33,P<0.01).At the same time,taking sputum culture as the standard,multiple PCR was highly sensitive in the detection of pathogens,with a sensitivity of 85.71%.Conclusion Multiplex PCR and sputum culture showed moderate consistency in pathogen detection,with multiplex PCR demonstrating higher sensitivity and shorter detection time.The use of multiplex PCR results to guide antibiotic therapy reduced unnecessary antibiotic use in clinical practice.

关 键 词：多重PCR 痰培养 肺部感染 下呼吸道感染 

分 类 号：R563.1[医药卫生—呼吸系统]