肺泡灌洗液病原靶向测序(BALF tNGS)对肺结核患者的临床应用价值研究

Clinical Application Value of Targeted Sequencing of Bronchoalveolar Lavage Fluid Pathogens(BALF tNGS)in Patients with Pulmonary Tuberculosis

探究肺泡灌洗液病原靶向测序(BALF tNGS)对肺结核患者的临床应用价值。选取黔西南布依族苗族自治州人民医院2022年10月—2023年11月收治的90例肺结核患者作为研究对象,收集患者的肺泡灌洗液(BALF),分别进行BALF tNGS及抗酸杆菌涂片检查。比较病原靶向测序与常规涂片检查的肺结核检出情况,包括灵敏度、特异度、阳性率及阳性结果一致性。结果显示,90例患者经病原靶向测序检出肺结核患者82例,抗酸染色检查检出肺结核患者60例。BALF tNGS与抗酸染色涂片检查相比,其灵敏度为96.77%(60/62),特异度为21.43%(6/28);BALF tNGS病原体阳性率高于抗酸杆菌涂片检查,差异有统计学意义(P<0.05)。研究发现,BALF tNGS技术不仅可以检测到不同株系的肺结核病原体,还可以对其耐药性进行分析,为制订个体化治疗方案提供重要依据。

Exploring the clinical application value of bronchoalveolar lavage fluid pathogen targeted sequencing(BALF tNGS)in patients with pulmonary tuberculosis.Ninety patients with pulmonary tuberculosis admitted to the Qiannan Buyi and Miao Auton-omous Prefecture Hospital from October 2022 to November 2023 were selected as the research subjects.The bronchoalveolar lavage fluid(BALF)of the patients was collected and subjected to BALF tNGS and acid fast bacteria smear examination.Compare the detection of tuberculosis between pathogen targeted sequencing and routine smear examination,including sensitivity,specificity,positivity rate,and consistency of positive results.The results showed that 82 out of 90 patients were diagnosed with pulmonary tuberculosis through pathogen targeted sequencing,and 60 patients were diagnosed with pulmonary tuberculosis through acid fast staining examination.Compared with acid fast staining smear examination,the sensitivity of BALF tNGS was 96.77%(60/62),and the specificity was 21.43%(6/28);The positivity rate of pathogens in BALF tNGS was higher than that in acid fast bacteria smear examination,and the difference was statistically significant(P<0.05).The study found that BALF tNGS technology can not only detect different strains of pulmonary tuberculosis pathogens,but also analyze their drug resistance,providing an important basis for the development of individualized treatment programs.