20例耶氏肺孢子菌肺炎的临床特点及宏基因组二代测序在其诊断中的价值

中国真菌学杂志　 2023, Vol. 18 　Issue (4): 296-300.

20例耶氏肺孢子菌肺炎的临床特点及宏基因组二代测序在其诊断中的价值

宫原, 宋新宇

三峡大学第一临床医学院, 宜昌市中心人民医院呼吸与危重症医学科, 宜昌 443003

收稿日期:2022-04-16 出版日期:2023-08-28 发布日期:2023-09-02
通讯作者: 宋新宇,E-mail:songxinyuhxk@126.com E-mail:songxinyuhxk@126.com
作者简介:宫原,女(土家族),博士,主治医师.E-mail:gina251@126.com
基金资助:
宜昌市科技局项目(A22-2-008)

Clinical characteristics of 20 cases of PJP and the value of NGS in the diagnosis of PJP

GONG Yuan, SONG Xinyu

Department of Medicine and Respiratory, First Clinical Medical College of Three Gorges University, Yi Chang Central People's Hospital, Institute of Respiratory Diseases, Three Gorges University, Yichang 443003, China

Received:2022-04-16 Online:2023-08-28 Published:2023-09-02

摘要/Abstract

摘要： 目的分析PJP的临床特征及高危因素,并探讨NGS在PJP诊断中的价值,以及PJP患者可能的预后指标。方法收集2020年4月—2021年12月我科收治的20例PJP患者的临床资料, 分析临床特点,比较治疗前后实验室指标差异及不同检测方法在诊断中的价值。结果 20例患者肺泡灌洗液NGS均提示肺孢子菌感染,血G试验阳性率90%,病原学涂片及培养阳性率为0。经抗PJP治疗后14例患者获得临床缓解,治疗前后外周血淋巴细胞计数差异具有统计学意义。结论 mNGS在PJP诊断中有较高参考价值,灵敏度明显高于常规病原学涂片及培养。相比G试验,NGS不仅可以识别感染病原菌并且灵敏度极高,具有明显优势。此外,外周血淋巴细胞与疾病的恢复正相关,可作为PJP患者预后的实验室标志之一。

关键词: 肺炎, 肺孢子菌, 免疫抑制剂, NGS, 淋巴细胞

Abstract: Objective To analyze the clinical features and high-risk factors of Pneumocystis jirovecii pneumonia (PJP), explore the value of metagenomic sequencing (mNGS) in the diagnosis of PJP, and seek possible prognostic indicators in PJP patients. Methods From April 2020 to December 2021, the clinical data of 20 PJP patients admitted to our department were collected, and their clinical characteristics were analyzed. The differences in laboratory indexes before and after treatment and the value of different detection methods in diagnosis were compared. Results Pneumocystis infection was detected by NGS in BALF of 20 patients, meanwhile, the positive rate of blood G test was 90%. However, neither smears nor cultures of the pathogen showed signs of pneumocystis infection. After anti-PJP treatment, 14 cases were clinically relieved, and the difference in peripheral blood lymphocyte. Conclusion Compared with the sensitivity of conventional etiological smears and cultures, mNGS showed better value in the diagnosis of PJP. NGS could identify pathogens with high sensitivity. In addition, peripheral blood lymphocytes were positively correlated with disease recovery and could be used as one of the laboratory markers of prognosis in PJP patients.

Key words: pneumonia, pneumocystis, immunosuppressive agent, NGS, lymphocytes

中图分类号:

R519

宫原, 宋新宇. 20例耶氏肺孢子菌肺炎的临床特点及宏基因组二代测序在其诊断中的价值[J]. 中国真菌学杂志, 2023, 18(4): 296-300.

GONG Yuan, SONG Xinyu. Clinical characteristics of 20 cases of PJP and the value of NGS in the diagnosis of PJP[J]. Chinese Journal of Mycology, 2023, 18(4): 296-300.

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