摘要
目的探讨结构性肺病合并肺部感染病原体检测中支气管肺泡灌洗液靶基因二代测序的应用。方法选取2023年1月至12月本院结构性肺病合并肺部感染74例作为结构性肺病组,另选取同期本院无结构性肺病50例作为无结构性肺病组。统计分析两组炎症指标、tNGS检出病原体分类,并统计分析肺泡灌洗液tNGS和传统培养(肺泡灌洗液、痰)患者的一般资料、炎症指标、tNGS检出病原体分类,分析肺泡灌洗液tNGS的诊断效能,以传统培养为金标准。结果有结构性肺病和无结构性肺病患者的白细胞计数、淋巴细胞计数、中性粒细胞计数、炎症指标升高率、tNGS病原体检出率比较差异均无统计学意义(P>0.05)。肺泡灌洗液tNGS的病毒、真菌、细菌检出率及总检出率均高于传统培养(P<0.05),但二者的衣原体、支原体检出率比较差异无统计学意义(P>0.05)。肺泡灌洗液tNGS的病原体检出率高于传统培养检查(P<0.05),但二者的年龄、性别、基础疾病、吸烟史、炎症指标比较差异均无统计学意义(P>0.05)。以传统培养为金标准,肺泡灌洗液tNGS的灵敏性为80.00%(4/5),特异性为4.35%(3/69),准确性为9.46%(7/74),阳性预测值为5.71%(4/70),阴性预测值为75.00%(3/4)。结论结构性肺病合并肺部感染病原体检测中支气管肺泡灌洗液二代测序的应用价值高于传统培养,且能够检出更广泛的病原体微生物种类,进而将病原体明确下来,从而有效治疗临床治疗。
Objective To explore the application of second-generation sequencing of target genes in bronchoalveolar lavage fluid for pathogen detection in structural lung disease complicated with pulmonary infection.Methods Seventy-four cases of structural lung disease complicated with pulmonary infection in our hospital from January to December 2023 were selected as the structural lung disease group,and another 50 cases of non structural lung disease in our hospital during the same period were selected as the non structural lung disease group.Statistical analysis of two sets of inflammatory indicators and pathogen classification detected by tNGS,and statistical analysis of general information,inflammatory indicators,and pathogen classification detected by tNGS in bronchoalveolar lavage fluid and traditional culture(bronchoalveolar lavage fluid,sputum)patients,to analyze the diagnostic efficacy of tNGS in bronchoalveolar lavage fluid,with traditional culture as the gold standard.Results There was no significant difference in the white blood cell count,lymphocyte count,neutrophil count,inflammatory index elevation rate,and tNGS pathogen detection rate between patients with structural lung disease and those without structural lung disease(P>0.05).The detection rates and total detection rates of viruses,fungi,and bacteria in bronchoalveolar lavage fluid tNGS were higher than those in traditional culture(P<0.05),but there was no significant difference in the detection rates of chlamydia and mycoplasma between the two(P>0.05).The pathogen detection rate of pulmonary lavage fluid tNGS was higher than that of traditional culture examination(P<0.05),but there were no significant differences in age,gender,underlying diseases,smoking history,and inflammatory indicators between the two(P>0.05).Using traditional culture as the gold standard,the sensitivity of tNGS in bronchoalveolar lavage fluid was 80.00%(4/5),specificity was 4.35%(3/69),accuracy was 9.46%(7/74),positive predictive value was 5.71%(4/70),and negative predictive value was 75.00%(3/4).Conclusions The application value of second-generation sequencing of bronchoalveolar lavage fluid in the detection of pathogens in structural lung disease complicated with pulmonary infection is higher than that of traditional culture,and it can detect a wider range of pathogenic microorganisms,thereby identifying pathogens and effectively treating clinical conditions.
作者
王良青
WANG Liangqing(Department of Respiratory Medicine,Pingtan Experimental Area Hospital,Fuzhou,Fujian 350400,China)
出处
《中国医药指南》
2025年第6期59-62,共4页
Guide of China Medicine
关键词
结构性肺病
肺部感染
病原体
支气管肺泡灌洗液
二代测序
传统培养
Structural lung disease
Pulmonary infection
Pathogen
Bronchoalveolar lavage fluid
Second-generation sequencing
Traditional cultivation
