摘要
目的总结10例宏基因组二代测序(mNGS)为阳性的重症肺念珠菌感染患者的临床特点与治疗经验。方法选取2020年1月至2021年12月期间云南省第一人民医院收治的10例重症肺念珠菌感染患者,其mNGS检测结果均为阳性。回顾性分析本组患者的临床资料,重点梳理患者的灌洗液基因测序结果、灌洗液培养结果、普通痰培养结果以及药物治疗方法,总结其本病的临床特点与诊疗经验。结果本组病例中,男9例,女1例,年龄41~82岁,主要临床表现为发热、咳嗽、咳痰。实验室检查发现,5例患者的血清降钙素原水平高于正常值,多数患者的C反应蛋白、红细胞沉降率、白细胞计数有明显升高趋势,胸部CT检查可见肺叶炎症与实变。本组患者的mNGS检测结果均为阳性,结合基因测序结果与患者的临床表现明确诊断。综合考虑实验室检查与mNGS检测结果,针对性设计用药方案,除1例患者用药效果较差、自动出院,其余患者经治疗后病情好转,达出院标准。结论mNGS的检测结果对重症肺念珠菌感染患者的诊疗有重要意义,可为用药方案的针对性设计提供重要参考。
Objective To summarize the clinical characteristics and treatment experience of 10 patients with severe pulmonary candidiasis who were positive for metagenomic second generation sequencing(mngs).Methods ten patients with severe pulmonary candidiasis admitted to Yunnan Provincial People's Hospital from january 2020 to December 2021 were selected,and their mngs test results were positive.Retrospective analysis of the clinical data of this group of patients,focusing on combing the results of gene sequencing in lavage fluid,lavage fluid culture,common sputum culture and drug treatment,and summarizing the clinical characteristics and diagnosis and treatment experience of this disease.Results There were 9 males and 1 female,aged 41-82 years.The main clinical manifestations were fever,cough and expectoration.The laboratory examination showed that the serum procalcitonin level of 5 patients was higher than the normal value,the C-reactive protein,erythrocyte sedimentation rate and leukocyte count of most patients had a significant upward trend,and the chest CT examination showed the inflammation and consolidation of lung lobes.The detection results of mngs in this group of patients were all positive,and the diagnosis was made by combining the gene sequencing results with the clinical manifestations of the patients.Based on the results of laboratory examination and mngs test,a targeted medication plan was designed.Except for one patient who had poor medication effect and was discharged automatically,the other patients improved after treatment and reached the discharge standard.Conclusion the detection results of mngs are of great significance for the diagnosis and treatment of patients with severe pulmonary candidiasis,and can provide an important reference for the targeted design of drug regimen.
作者
夏宜兰
梁晓
吴东娜
蒋淑一
左丽丽
XIA Yi-lan;LIANG Xiao;WU Dong-na;JIANG Shu-yi;ZUO Li-li(Yunnan Provincial People's Hospital,Kunming 650032,Yunnan Province,China)
出处
《罕少疾病杂志》
2026年第1期59-62,共4页
Journal of Rare and Uncommon Diseases
关键词
重症肺念珠菌感染
宏基因组二代测序
临床特点
药物治疗
Severe Pulmonary Candidiasis
Metagenome Second Generation Sequencing
Clinical Features
Medication
