临床误诊误治2025，Vol.38Issue(1)：45-49,5.DOI:10.3969/j.issn.1002-3429.2025.01.011
肺泡灌洗液快速现场评价联合宏基因组二代测序在重症肺炎患者中的应用价值
Application Value of Rapid On-site Evaluation of Alveolar Lavage Fluid Combined with Metagenomic Next-generation Sequencing in Patients with Severe Pneumonia
摘要
Abstract
Objective To investigate the application value of rapid on-site evaluation(ROSE)of alveolar lavage flu-id combined with metagenomic next-generation sequencing(mNGS)in patients with severe pneumonia.Methods A pro-spective study was conducted on 94 patients with severe pneumonia treated from October 2021 to April 2024,and they were randomly divided into the control group(routine etiological examination,n=47)and the observation group(ROSE combined with mNGS technology for etiological examination,n=47),all of whom were given antibiotics.The effective pathogen detec-tion rate of alveolar lavage fluid,antibiotic application,fever time,duration of mechanical ventilation and intensive care unit(ICU)stay were recorded in the two groups,and the clinical pulmonary infection score(CPIS)and serum peripheral blood C-reactive protein(CRP)and procalcitonin(PCT)levels were compared between the two groups at 1,4 and 7 d after admis-sion.Results The effective pathogen detection rate of alveolus lavage fluid in the observation group was 97.87%(46/47),which was higher than that of the control group[59.57%(28/47)](P＜0.05),and viruses and uncommon pathogens(such as chlamydia pectin,Mycobacterium tuberculosis,Mycobacterium kansans)could be detected in the observation group.Compared with the control group,the time of antibiotic use,fever time,duration of mechanical ventilation and length of ICU stay in the observation group were shorter,and the types of antibiotics used and the frequency of adjustment were less(P＜0.05).The levels of CPIS,serum CRP and PCT in peripheral blood of the two groups on the 4th and 7th day after admission were lower than those on the 1st day,and decreased with the increase of treatment time(P＜0.05).Compared with the con-trol group,CPIS score,CRP and PCT levels in peripheral blood of the observation group were decreased on the 4th and 7th day after admission(P＜0.05).Conclusion ROSE combined with mNGS technology has a high application value in pa-tients with severe pneumonia,which can improve the etiological detection rate and identify the pathogen in time,so as to rap-idly guide clinical precision treatment.关键词
重症肺炎/快速现场评价/宏基因组二代测序/病原体/肺泡灌洗液/临床肺部感染评分/C反应蛋白/降钙素原Key words
Severe pneumonia/Rapid on-site evaluation/Metagenomic next-generation sequencing/Pathogen/Alve-olar lavage fluid/Clinical pulmonary infection score/C reactive protein/Procalcitonin分类
医药卫生引用本文复制引用
刘亚萌,李冠英,刘翠,朱劲松,张胜利,梁希军..肺泡灌洗液快速现场评价联合宏基因组二代测序在重症肺炎患者中的应用价值[J].临床误诊误治,2025,38(1):45-49,5.基金项目
沧州市重点研发计划指导项目(222106117) （222106117）
