应用mNGS技术指导支气管扩张症的临床研究——基于100例患者的研究

摘要/Abstract

摘要： 目的探讨与分析应用基因组测序（mNGS）技术指导支气管扩张症治疗的临床效果。方法选择2019年8月—2022年11月在广东省佛山市南海区第四人民医院诊治的100例支气管扩张症患者作为研究对象,根据随机数表法把患者分为mNGS组与对照组,每组50例。对照组给予支气管镜检查并进行肺泡灌洗治疗,mNGS组在对照组治疗的基础上给予基因组测序分析并指导临床治疗,两组治疗观察时间为1个月,分析比较两组的疗效、血气指标变化、临床症状的改善时间、不良反应和肺功能变化等。结果 mNGS组治疗总有效率显著高于对照组,差异有统计学意义（P<0.05）。治疗1个月后,两组动脉氧分压与血氧饱和度均明显高于治疗前,且mNGS组动脉氧分压与血氧饱和度明显高于对照组,差异有统计学意义（P<0.05）。mNGS组的肺部啰音消失时间、咳嗽咳痰消失时间、体温恢复正常时间均明显短于对照组,差异有统计学意义（P<0.05）。mNGS组头痛、皮疹、失眠、胃肠道不适等不良反应总发生率显著低于对照组,差异有统计学意义（P<0.05）。治疗1个月后,两组第1秒用力呼气量（FEV₁）、用力肺活量（FVC）均明显高于治疗前,且mNGS组FEV₁、FVC明显高于对照组,差异有统计学意义（P<0.05）。结论用mNGS技术指导支气管扩张症的临床治疗能减少患者的肺部啰音消失时间、咳嗽咳痰消失时间、体温恢复正常时间,提高患者的治疗效果,改善患者的动脉氧分压与血氧饱和度,减少不良反应发生发生,提高患者的肺功能。

关键词: 基因组测序技术, 支气管扩张症, 肺部啰音, 动脉氧分压, 血氧饱和度, 肺功能

Abstract: Objective To explore and analysis the application of genome sequencing (The mNGS technology guides the clinical effects of bronchiectasis. Methods From August 2019 to November 2022, 100 patients with bronchiectasis treated in the Fourth People's Hospital of Nanhai District, Foshan City, Guangdong Province were selected as the study subjects, 50 patients in mNGS group and 50 in control group according to random 1:1 numerical table. The control group were given bronchoscopy and alveolar lavage treatment. The mNGS group were given genome sequencing analysis and guided clinical treatment on the basis of the treatment of the control group. The treatment observation time of the two groups were 1 month, and the efficacy, changes in blood gas indicators, improvement time of clinical symptoms, adverse reactions and Changes in lung functionof the two groups were analyzed. Results The total effective rates of the mNGS group after 1 month of treatment were significantly higher than the control group (P<0.05). The arterial oxygen partial pressure and blood oxygen saturation of the two groups after 1 month of treatment were significantly higher than those before treatment (P<0.05), and the mNGS group were also significantly higher than the control group (P<0.05). The disappearance time of lung rale, cough and sputum, and the time of body temperature returning to normal in the mNGS group were significantly reduced compared with the control group (P<0.05). The incidence of adverse reactions such as headache, rash, insomnia and gastrointestinal discomfort after treatment in the mNGS group were significantly lower than that in the control group (P<0.05). After 1 month of treatment, forced expiratory volume (FEV₁) and forced vital capacity (FVC) of 1s in two groups were significantly increased compared with before treatment (P<0.05), and mNGS group was also significantly increased compared with control group (P<0.05). Conclusion Using mNGS technology to guide the clinical treatment of bronchiectasis can reduce the time for the disappearance of lung rale, cough and sputum, and the time for the temperature to return to normal, improve the treatment effect of patients, improve the arterial oxygen partial pressure and blood oxygen saturation of patients, reduce the incidence of adverse reactions, and also improve the lung function of patients.

Key words: genome sequencing technology, bronchiectasis, lung rale, arterial oxygen partial pressure, blood oxygen saturation, pulmonary function

中图分类号:

R562.2+2

甘长友, 谢浩, 潘保永, 万绮琪, 邓伟棠, 甘华林, 曾婷婷, 肖体江, 陆烨大. 应用mNGS技术指导支气管扩张症的临床研究——基于100例患者的研究[J]. 中华养生保健, 2023, 41(19): 15-18.

GAN Chang-you, XIE Hao, PAN Bao-yong, WAN Qi-qi, DENG Wei-tang, GAN Hua-lin, ZENG Ting-ting, XIAO Ti-jiang, LU Ye-da. Application of mNGS Technology to Guide the Clinical Study of Bronchiectasis - Based on the Study of 100 Patients[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(19): 15-18.

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