目的 探讨肺泡灌洗液病原靶向测序（Balf tNGS）早期诊断非结核分枝杆菌肺病（NTM-PD）合并肺真菌病的价值。方法 对本院67例影像学恶化的疑似NTM-PD合并肺真菌病患者采集BALF标本进行tNGS检测及真菌培养鉴定并结果对比评价。结果 Balf tNGS检测共有56例检出真菌,检出率83.58%,占比排前3位是烟曲霉菌、白色念珠菌、赛多孢菌属。tNGS与真菌培养鉴定两种方法在真菌的检测能力采用配比χ2检验方法进行对比,配对卡方检验结果P<0.001,差异有意义,说明tNGS检测明显优于真菌培养鉴定。结论 Balf tNGS对NTM-PD影像学恶化的病例能够提供病原学诊断参考,对合并肺真菌病的早期诊断有积极的意义。
Abstract
Objective To investigate the value of pathogen targeted sequencing in alveolar lavage fluid (Balf tNGS) in early diagnosis of non-tuberculous mycobacterium lung disease (NTM-PD) complicated with pulmonary mycosis. Methods BALF samples were collected from 67 suspected NTM-PD patients with pulmonary mycosis who showed imaging deterioration at our hospital for tNGS detection and fungal culture identification, and the results were compared and evaluated. Results A total of 56 fungi were detected by Balf tNGS, the detection rate was 83.58%, and the top 3 fungi were Aspergillus fumigatus, Candida albicans and Sedospora. The results of paired Chi-square test (P<0.001) were significant, indicating that tNGS detection was significantly superior to fungal culture identification. Conclusions BALF tNGS can provide a pathogenic diagnostic reference for cases of NTM-PD imaging deterioration, and is of positive significance for early diagnosis of pulmonary mycosis.
关键词
非结核分枝杆菌肺病 /
肺真菌病 /
支气管肺泡灌洗液
Key words
Non tuberculosis mycobacterial disease /
Pulmonary mycosis /
Bronchoalveolar lavage fluid
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基金
广州市科学技术局基础与应用基础研究项目（No.2023A03J0991）; 广州市科技计划项目（No.2023A03J0539）
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