摘要
目的:探讨宏基因组二代测序对下呼吸道感染诊断治疗的价值。方法:收集2019年11月至2022年11月江西省宜春市人民医院收治的下呼吸道感染患者100例。采取随机数字表法分为两组,每组50例。A组纤支镜肺泡灌洗液接受宏基因组二代测序(metagenomic next generation sequencing,mNGS)及常规培养、细菌、真菌涂片或PCR等传统检测。B组纤支镜肺泡灌洗液采用常规培养、细菌、真菌涂片或PCR等传统检测。分析两组检测耗时及诊断价值,评定两组急性生理与慢性健康评分Ⅱ(APACHEⅡ);检测两组白细胞(white blood cell,WBC)、降钙素原(proealcitonin,PCT)及C-反应蛋白(C-reactive protein,CRP);观察两组体温、啰音、CRP、WBC、胸片检查改善时间;比较两组临床疗效。结果:A组经临床最终诊断确诊43例为下呼吸道感染;B组41例为下呼吸道感染。A组检测耗时短于B组,且诊断下呼吸道感染的灵敏度和准确度均高于B组(P<0.05)。治疗后,两组APACHEⅡ评分、WBC、PCT及CRP水平均低于治疗前(P<0.05),且A组低于B组(P<0.05)。A组体温、啰音、CRP、WBC、胸片检查改善时间均早于B组(P<0.05)。A组治疗总有效率为100.00%,高于B组的80.00%(P<0.05)。结论:mNGS对下呼吸道感染的诊断价值较好,可以辅助临床诊治,值得临床推荐。
Objective:To explore the value of second generation sequencing of macrogenome in the diagnosis and treatment of lower respiratory tract infection.Methods:One hundred patients with lower respiratory tract infection admitted to Yichun People’s Hospital,Jiangxi Province from November 2019 to November 2022 were collected.They were divided into two groups with 50 cases each using a random number table method.Bronchoscopy alveolar lavage fluid of Group A was sent for mNGS detection and traditional tests such as routine culture,bacterial and fungal smears,or PCR were used.Bronchoscopy alveolar lavage fluid of Group B was tested using conventional methods such as culture,bacterial and fungal smears,or PCR.The time consumption and diagnostic value of two sets of tests were analyzed to evaluate the acute physiology and chronic health evaluationⅡ(APACHE II)scores of both groups;white blood cell(WBC),proealcitonin(PCT)and C-reactive protein(CRP)were detected in the two groups;the improvement time of body temperature,rale,CRP,WBC,and chest X-ray examination in two groups were observed;the clinical efficacy of two groups were compared.Results:In Group A,43 cases of lower respiratory tract infection were finally diagnosed;in Group B 41 cases of lower respiratory tract infection were diagnosed.The detection time in Group A was shorter than that in Group B,and the sensitivity and accuracy of diagnosing lower respiratory tract infection in Group A were higher than those in Group B(P<0.05).After treatment,the APACHE II score,WBC,PCT,and CRP levels in both groups were lower than those before treatment(P<0.05),and Group A was lower than Group B(P<0.05).The improvement time of body temperature,rale,CRP,WBC,and chest X-ray examination in Group A was earlier than those in Group B(P<0.05).The total effective rate of treatment was 100.00%in Group A,which was higher than 80.00%in Group B(P<0.05).Conclusion:The second generation sequencing of macrogenome has good diagnostic value for lower respiratory tract infection,which can assist cl
作者
刘莉琼
刘露
黄晖
徐艳
万敏娜
LIU Liqiong;LIU Lu;HUANG Hui;XU Yan;WAN Minna(Respiratory Department of Yichun People’s Hospital,Yichun 336000,Jiangxi Province,China;General Medicine Department of Yichun People’s Hospital,Yichun 336000,Jiangxi Province,China)
出处
《上海医药》
CAS
2023年第22期34-37,52,共5页
Shanghai Medical & Pharmaceutical Journal
基金
江西省卫生健康委员会科技计划项目(202312216)。
关键词
下呼吸道感染
宏基因组二代测序
诊断
价值
lower respiratory tract infection
second generation sequencing of macrogenome
diagnosis
value
