血行播散型结核的临床研究进展

Clinical Research Progress on Hematogenous Disseminated Tuberculosis

血行播散型结核作为一种罕见的结核病,重症死亡率高。患者的临床表现不典型,传统的血培养耗时长、敏感性低,常导致诊断和治疗的延误。mMGS (metagenomic next-generation sequencing)作为一种新兴的微生物检测手段,已经越来越多被用于结核病的诊断。本文对血行播散型结核的临床症状、实验室及影像学检查、病理学特点、发病机制、诊断方法、治疗方案进行回顾,分析了mMGS在血行播散型结核中的应用价值,为该病在临床实践中的早期识别和诊断提供方向。

Hematogenous disseminated tuberculosis is a rare form of tuberculosis with a high mortality rate. The clinical manifestations of the patients are not typical, and the traditional blood culture is time-consuming and low sensitivity, which often leads to the delay of diagnosis and treatment. mMGS (metagenomic next-generation sequencing), as an emerging means of microbial detection, has been increasingly used for the diagnosis of tuberculosis. In this paper, the clinical symptom, laboratory and imaging examinations, pathological features, pathogenesis, diagnostic methods and treatment of hematogenous disseminated tuberculosis were reviewed, and the application value of mMGS in hematogenous disseminated tuberculosis was analyzed, providing directions for the early recognition and diagnosis of this disease in clinical practice.