中国实用外科杂志2025，Vol.45Issue(10)：1155-1160,6.DOI:10.19538/j.cjps.issn1005-2208.2025.10.16
宏基因捕获法二代测序动态检测在合并长程器官功能衰竭的急性胰腺炎中应用价值研究
The clinical significance of metagenomics capture next generation sequencing dynamic detection in acute pancreatitis complicated by prolonged organ failure
摘要
Abstract
Objective To evaluate the clinical utility of continuous dynamic testing using the Metagenomic Capture(MetaCAP)next-generation sequencing technique in severe acute pancreatitis(SAP)patients complicated by prolonged organ failure(Pro-OF).Methods A prospective analysis was conducted on 65 SAP patients with Pro-OF from Xiangya Hospital of Central South University and Hunan Medical College General Hospital between January 2024 and September 2025.All patients underwent weekly peripheral blood MetaCAP dynamic detection to assess its di-agnostic efficacy and prognostic value.Results Among the 65 Pro-OF patients,a total of 101 blood MetaCAP tests were performed,with a posi-tivity rate of 51.5％(52/101),significantly higher than the positivity rate of traditional blood culture(25.7％,P=0.005).The overall concordance rate between MetaCAP pathogen detection results and microbiological culture results from various sampling sites was 90.9％,with concordance rates of 85.2％and 67.9％for peripancreatic and respiratory specimens,respectively.When organ failure duration exceeded two weeks,the MetaCAP positivity rate surged from 27.5％to 61.1％,whereas white blood cell count,C-reactive protein,and procalcitonin levels showed no similar trends.In patients undergoing continuous MetaCAP dynamic monitoring,mortality was significantly higher in those with persistently positive results compared to those with persistently negative results(58.8％vs.11.1％,P=0.036).Conclusions In patients with SAP,prolonged duration of organ failure is associated with an increased risk of bloodstream infection(BSI),predominantly originating from peripancreatic and respiratory infections.Continuous dy-namic monitoring of blood samples using MetaCAP not only provides accurate guidance for clinical anti-infective therapy,but also holds significant prognostic value for SAP patients complicated with Pro-OF.关键词
重症急性胰腺炎/持续性器官功能衰竭/胰周感染/感染检测Key words
severe acute pancreatitis/prolonged organ failure/peripancreatic infection/infection detection分类
医药卫生引用本文复制引用
孙泽芳,申鼎成,刘志勇,周建亮,黄耿文,张译之,余艳,李嘉荣,郭蓉,刘柏岐,林嘉晏,曹昕彤,陈璐..宏基因捕获法二代测序动态检测在合并长程器官功能衰竭的急性胰腺炎中应用价值研究[J].中国实用外科杂志,2025,45(10):1155-1160,6.基金项目
国家自然科学基金项目(No.82403227) （No.82403227）
湖南省自然科学基金项目(No.2025JJ90283) National Natural Science Foundation of China(No.82403227) （No.2025JJ90283）
Provincial Natural Science Foundation of Hunan(No.2025JJ90283) （No.2025JJ90283）
