首页|肺泡灌洗液病原微生物宏基因二代测序技术在难治性肺炎治疗中的应用效果

肺泡灌洗液病原微生物宏基因二代测序技术在难治性肺炎治疗中的应用效果

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目的 探讨肺泡灌洗液病原微生物宏基因二代测序技术(NGS)在难治性肺炎治疗中的应用价值,以期为临床治疗提供参考.方法 本研究选取2021年6月—2023年6月衡水市第二人民医院收治的200例难治性肺炎患者为研究对象.采用随机数字表法将患者分为对照组与观察组,每组100例.对照组患者采用肺泡灌洗液传统检测法检测后,实施经验性治疗.观察组患者采用肺泡灌洗液NGS检测后,实施精准治疗.比较2组患者病原菌阳性率、治疗效果及住院相关指标;比较2组患者治疗前后炎症因子水平;比较2组患者治疗后肺炎严重程度.结果 观察组患者病原菌总阳性率高于对照组,差异有统计学意义(P<0.05).治疗前,2组患者白细胞计数、(C反应蛋白)CRP、血清淀粉样蛋白A(SAA)、降钙素原(PCT)水平比较,差异无统计学意义(P>0.05).治疗后,2组患者白细胞计数、CRP、SAA、PCT水平均低于治疗前,且观察组低于对照组,差异均有统计学意义(P<0.05).观察组患者CURB-65评分、急性生理与慢性健康(APACHEⅡ)评分及多层螺旋CT(MSCT)影像学征象异常改变占比均低于对照组,差异均有统计学意义(P<0.05).观察组患者治愈率高于对照组,差异有统计学意义(P<0.05).相较于对照组,观察组患者机械通气时间更短,住院时间更短,住院费用更少,差异均有统计学意义(P<0.05).结论 采用肺泡灌洗液NGS检测后实施的精准治疗对于难治性肺炎而言效果更好,其能提高病原菌阳性检出率,降低炎症因子水平,减轻肺炎严重程度,提高患者治愈率,减少医疗费用,具有较高经济效益与社会效益.
Application effectiveness of next-generation sequencing technology for pathogenic microorganisms in bronchoalveolar lavage fluid on refractory pneumonia
Objective To explore the application value of next-generation sequencing (NGS) technology for pathogenic micro-organisms in bronchoalveolar lavage fluid in the treatment of refractory pneumonia,providing a reference for clinical treat-ment.Methods A total of 200 patients with refractory pneumonia admitted to the Second People's Hospital of Hengshui from June 2021 to June 2023 were selected.Patients were randomly allocated to a control group and an observation group,with 100 cases in each group.The control group received empirical treatment after traditional detection methods for bron-choalveolar lavage fluid,while the observation group received precise treatment after NGS detection.The positive rate of pathogens,treatment outcomes,and hospitalization indicators were compared between the two groups.Inflammatory factor levels before and after treatment were also compared.Results The overall positive rate of pathogens in the observation group was significantly higher than in the control group (P<0.05).Before treatment,no significant difference was ob-served in white blood cell count,CRP,SAA,and PCT levels between the two groups (P>0.05).After treatment,these levels were significantly lower in both groups,with the observation group showing lower levels than the control group (P<0.05).The CURB 65 score,APACHE Ⅱ score,and MSCT abnormal imaging changes were significantly lower in the ob-servation group compared to the control group (P<0.05).The cure rate in the observation group was significantly higher than in the control group (P<0.05).The observation group also had a significantly shorter duration of mechanical ventila-tion,shorter length of hospital stay,and lower hospitalization costs compared to the control group (P<0.05).Conclusion Precise treatment following NGS detection of bronchoalveolar lavage fluid is more effective for patients with refractory pneu-monia,as it increases the detection rate of pathogenic bacteria,reduces inflammatory factors,alleviates the severity of pneu-monia,raises cure rates,and reduces medical costs,offering marked economic and social benefits.

BronchoscopeBronchoalveolar lavage fluidRefractory pneumoniaCure rate

张方、王娜、孟君、赵智东、崔存晓、任成波

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河北省衡水市第二人民医院呼吸内科,河北衡水 053000

承德医学院附属衡水市人民医院全科医学科,河北衡水 053000

河北北方学院附属第一医院呼吸内科,河北张家口 050051

支气管镜 肺泡灌洗液 难治性肺炎 治愈率

2022年度河北省医学科学研究课题

20220618

2024

保健医学研究与实践
西南大学

保健医学研究与实践

CSTPCD
影响因子:0.512
ISSN:1673-873X
年,卷(期):2024.21(4)
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