摘要
目的为提高慢性阻塞性肺疾病(COPD)合并真菌感染诊断方法的准确性,针对当前传统诊断方法灵敏度和特异度均不理想的问题,本研究主要探究支气管肺泡灌洗液宏基因组二代测序(mGNS)技术联合炎症因子对该病的诊断价值,旨在为临床诊断提供可靠依据。方法选取2022年6月—2024年6月新疆维吾尔自治区人民医院收治的102例COPD合并真菌感染患者作为真菌组、102例COPD未合并感染患者作为无感染组。比较2组临床资料、炎症因子[肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、白介素-2(IL-2)]水平,采用Pearson相关性分析研究炎症因子与肺功能[第1秒用力呼气量(FEV 1)、用力肺活量(FVC)、FEV 1/FVC]的相关性,采用ROC曲线分析mGNS、炎症因子对COPD合并真菌感染的诊断价值。结果真菌组糖尿病、低蛋白血症比例、血清TNF-α、IL-6、IL-2水平高于无感染组,FEV 1、FVC、FEV 1/FVC低于无感染组(P<0.05);血清TNF-α、IL-6、IL-2水平与肺功能均呈负相关关系(P<0.05);血清TNF-α、IL-6、IL-2诊断COPD合并真菌感染的AUC为0.793、0.754、0.778;mGNS诊断COPD合并真菌感染的灵敏度为91.18%,特异度为86.27%;mGNS联合血清TNF-α、IL-6、IL-2诊断COPD合并真菌感染的AUC为0.960,联合预测价值最大(P<0.05)。结论mGNS联合血清TNF-α、IL-6、IL-2在诊断COPD合并真菌感染中具有较高的临床价值。
Objective To improve the accuracy of diagnostic methods for chronic obstructive pulmonary disease(COPD)complicated with fungal infections.In response to the unsatisfactory sensitivity and specificity of traditional diagnostic methods,the main focus of this study is to explore the diagnostic value of bronchoalveolar lavage fluid mGNS technology combined with inflammatory factors for this disease,aiming to provide a reliable basis for clinical diagnosis.Methods A total of 102 patients with COPD complicated with fungal infection admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from June 2022 to June 2024 were selected as the fungal infection group,and 102 patients with COPD without infection were selected as the non-infection group.The clinical data and levels of inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-2(IL-2)]were compared between the two groups.Pearson analysis was used to investigate the correlation between inflammatory factors and lung function[forced expiratory volume in one second(FEV1),forced vital capacity(FVC),FEV 1/FVC].Receiver operating characteristic(ROC)curves were used to analyze the diagnostic value of mGNS and inflammatory factors for COPD complicated with fungal infections.Results The proportion of diabetes and hypoproteinemia,serum TNF-α,IL-6,and IL-2 levels in the fungal infection group were higher than those in the non-infection group,while FEV1,FVC,and FEV 1/FVC were lower than those in the non-infection group(P<0.05).The levels of serum TNF-α,IL-6,and IL-2 were negatively correlated with lung function(P<0.05).The AUC of serum TNF-α,IL-6,and IL-2 for diagnosing COPD with fungal infection were 0.793,0.754,and 0.778,respectively.The sensitivity and specificity of mGNS in diagnosing COPD complicated with fungal infection were 91.18%and 86.27%,respectively.The AUC of mGNS combined with serum TNF-α,IL-6,and IL-2 for the diagnosis of COPD with fungal infection was 0.960,and the combined predictive value was the highest(P<0.05).Conclusion The combination of mGNS and serum TNF-α,IL-6,and IL-2 has high clinical value in the diagnosis of COPD complicated with fungal infection.
作者
代建霞
刘媛
于媛媛
宋金萍
DAI Jianxia;LIU Yuan;YU Yuanyuan;SONG Jinping(Clinical Laboratory Center,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang 830000,China)
出处
《中华全科医学》
2026年第1期27-30,39,共5页
Chinese Journal of General Practice
基金
新疆维吾尔自治区人民医院院内项目(20240123)
新疆维吾尔自治区自然科学基金项目(2022D01C617)。
关键词
慢性阻塞性肺疾病
支气管肺泡灌洗液
宏基因组二代测序技术
炎症因子
真菌感染
Chronic obstructive pulmonary disease
Bronchoalveolar lavage fluid
Metagenomics next-generation sequencing technology
Inflammatory factors
Fungal infection
