目的:探讨宏基因组二代测序(mNGS)在非人类免疫缺陷病毒(HIV)感染患者中耶氏肺孢子菌肺炎(PJP)的诊断价值和其对治疗的指导价值。方法:采用回顾性研究方法,共纳入武汉大学中南医院2017年1月至2022年7月非HIV感染PJP患者73例和诊断为非PJ...目的:探讨宏基因组二代测序(mNGS)在非人类免疫缺陷病毒(HIV)感染患者中耶氏肺孢子菌肺炎(PJP)的诊断价值和其对治疗的指导价值。方法:采用回顾性研究方法,共纳入武汉大学中南医院2017年1月至2022年7月非HIV感染PJP患者73例和诊断为非PJP患者70例。分析了支气管肺泡灌洗液(BALF)中耶氏肺孢子菌(PJ)和其他共病原体情况,以临床复合诊断为参考标准,比较mNGS、聚合酶链式反应(PCR)和血清1,3‑β‑D‑葡聚糖(BDG)在PJP中的诊断效能,将纳入研究的PJP患者根据是否行mNGS分为行mNGS组和未行mNGS组,通过非参数秩和检验对比两组治疗情况。结果:本研究共纳入非HIV感染PJP患者73例,其中46例患者行mNGS检测,统计分析结果显示,相较于PCR、BDG,mNGS在诊断非HIV感染PJP的灵敏度(97.8%)和特异度(95.2%)更高。同时,mNGS在混合感染的检出率明显高于传统病原学检测(87.0%vs 63.0%,P=0.018),其中以白色念珠菌、人类疱疹病毒5型(CMV)、人类疱疹病毒1型(HSV1)最为常见。并且,在46例患者mNGS结果回报后,71.7%的PJP患者对最初的治疗方案进行了调整,其中57.6%患者经调整治疗方案后好转出院。与未行mNGS检测的非HIV感染PJP患者相比,行mNGS的患者住院时间更短[16(9,24)d vs 26(16,41)d],抗生素疗程更短[12(6,16)d vs 20(11,31)d],差异均有统计学意义(均P<0.05)。结论:mNGS对非HIV感染PJP的诊断效能高,且对于共病原体检出具有更好的性能,对临床诊断和指导针对性抗感染药物治疗具有一定的价值。展开更多
I went to America two months ago. The first city that I went to was Detroit. The air there was very clear, and had no noise nor pollution. I lived in a family. My host familys name is Charade Whitson. She is a very lo...I went to America two months ago. The first city that I went to was Detroit. The air there was very clear, and had no noise nor pollution. I lived in a family. My host familys name is Charade Whitson. She is a very lovely girl. She is thirteen years old. Her family has five people; her father, her mother, her two brothers and her. We lived in a villa (别墅) . The house was very big, and had two floors. I have lived there for two weeks. In these weeks, I had a good time. They often took me to everywhere that I展开更多
文摘目的:探讨宏基因组二代测序(mNGS)在非人类免疫缺陷病毒(HIV)感染患者中耶氏肺孢子菌肺炎(PJP)的诊断价值和其对治疗的指导价值。方法:采用回顾性研究方法,共纳入武汉大学中南医院2017年1月至2022年7月非HIV感染PJP患者73例和诊断为非PJP患者70例。分析了支气管肺泡灌洗液(BALF)中耶氏肺孢子菌(PJ)和其他共病原体情况,以临床复合诊断为参考标准,比较mNGS、聚合酶链式反应(PCR)和血清1,3‑β‑D‑葡聚糖(BDG)在PJP中的诊断效能,将纳入研究的PJP患者根据是否行mNGS分为行mNGS组和未行mNGS组,通过非参数秩和检验对比两组治疗情况。结果:本研究共纳入非HIV感染PJP患者73例,其中46例患者行mNGS检测,统计分析结果显示,相较于PCR、BDG,mNGS在诊断非HIV感染PJP的灵敏度(97.8%)和特异度(95.2%)更高。同时,mNGS在混合感染的检出率明显高于传统病原学检测(87.0%vs 63.0%,P=0.018),其中以白色念珠菌、人类疱疹病毒5型(CMV)、人类疱疹病毒1型(HSV1)最为常见。并且,在46例患者mNGS结果回报后,71.7%的PJP患者对最初的治疗方案进行了调整,其中57.6%患者经调整治疗方案后好转出院。与未行mNGS检测的非HIV感染PJP患者相比,行mNGS的患者住院时间更短[16(9,24)d vs 26(16,41)d],抗生素疗程更短[12(6,16)d vs 20(11,31)d],差异均有统计学意义(均P<0.05)。结论:mNGS对非HIV感染PJP的诊断效能高,且对于共病原体检出具有更好的性能,对临床诊断和指导针对性抗感染药物治疗具有一定的价值。
文摘I went to America two months ago. The first city that I went to was Detroit. The air there was very clear, and had no noise nor pollution. I lived in a family. My host familys name is Charade Whitson. She is a very lovely girl. She is thirteen years old. Her family has five people; her father, her mother, her two brothers and her. We lived in a villa (别墅) . The house was very big, and had two floors. I have lived there for two weeks. In these weeks, I had a good time. They often took me to everywhere that I
