二代测序技术在结核性脑膜炎早期诊断中的意义

Significance of next-generation sequencing in early diagnosis of tuberculous meningitis

目的评价脑脊液二代测序在结核性脑膜炎患者中的诊断价值。方法选取2017年1月至12月在河南省人民医院就诊的结核性脑膜炎患者7例,对患者脑脊液同时应用脑脊液常规、生化、培养、抗酸染色等传统检测方法及脑脊液二代测序进行检验,对患者的临床表现、实验室检查结果及测序结果进行综合分析。结果 7例患者脑脊液培养、抗酸染色均为阴性,脑脊液二代测序检测到结核分支杆菌的核酸序列数1~42条,诊断性抗结核药物治疗均有效,所以7例患者的结核性脑膜炎诊断成立。结论脑脊液二代测序可快速检测结核性脑膜炎的病原体,可用于早期辅助诊断结核性脑膜炎。

Objective To evaluate the diagnostic value of next-generation sequencing in patients with tuberculous meningitis.Methods Seven patients with tuberculous meningitis treated in Henan Provincial People’s Hospital from January to December 2017 were enrolled.The cerebrospinal fluid was used for routine cerebrospinal fluid,biochemical,culture,acid-fast staining and other next-generation sequencing of cerebrospinal fluid.Comprehensive analysis of the patient’s clinical performance,laboratory results and sequencing results.Results The cerebrospinal fluid culture and acid-fast staining were negative in all patients.The next-generation sequencing of cerebrospinal fluid detected 1 to 42 nucleic acid sequences of Mycobacterium tuberculosis,and the diagnostic anti-tuberculosis drugs were effective,so the diagnosis of seven patients with tuberculous meningitis is established.Conclusion Next-generation sequencing can quickly detect the pathogen of tuberculous meningitis and can be used for early diagnosis of tuberculous meningitis.