| 温雅,黄娟,杜焰家,等.环介导等温扩增技术检测慢性阻塞性肺疾病伴下呼吸道感染病原菌397 例价值研究[J].安徽医药,2022,26(9):1760-1766. |
| 环介导等温扩增技术检测慢性阻塞性肺疾病伴下呼吸道感染病原菌397 例价值研究 |
| Study on the value of loop mediated isothermal amplification technology in detecting pathogenic bacteria in 397 cases of chronic obstructive pulmonary disease with lower respiratory tract infection |
| |
| DOI：10.3969/j.issn.1009-6469.2022.09.015 |
| 中文关键词: 肺疾病，慢性阻塞性 呼吸道感染 核酸扩增技术 病原菌 环介导等温扩增技术 回顾性分析 痰液 |
| 英文关键词: Pulmonary disease, chronic obstructive Respiratory tract infections Nucleic acid amplification techniques Pathogenic bacteria Loop-mediated isothermal amplification technology Retrospective analysis Sputum Bronchoalveolar lavage fluid |
| 基金项目:广东省医学科研基金(B2021378)；梅州市人民医院科研培育项目(PY-C2020026) |
|
| 摘要点击次数: 864 |
| 全文下载次数: 349 |
| 中文摘要: |
| 目的探讨环介导等温扩增技术(LAMP)，即呼吸道病原菌核酸联合检测(13联)对慢性阻塞性肺疾病(COPD)伴下呼吸道感染病原菌检测的临床应用价值。方法选取梅州市人民医院2018年1月至2020年12月住院病人临床诊断为COPD伴急性下呼吸道感染的病例397例，其中有入住普通病房的病例195例，需要呼吸机辅助通气而入住重症监护室的病例202例，每例病人均留取痰液/支气管肺泡灌洗液/支气管吸出物送检LAMP(13联)检测和病原菌培养，比较入住不同病房治疗的COPD伴下呼吸道感染病原菌经LAMP(13联)检测出的病原菌分布特点，计算LAMP(13联)检测的灵敏度和特异度，以及统计分析LAMP(13联)检测与传统培养方法检测结果的一致性，探讨LAMP(13联)方法对COPD伴下呼吸道感染的临床应用价值。结果LAMP检测方法对普通病房、重症监护室的COPD伴下呼吸道感染病原菌的检测阳性率分别为45.13%、47.03%，均比传统培养方法高(P<0.05)；根据LAMP 检测结果，入住普通病房的COPD 病人感染病原菌排在前三名为流感嗜血杆菌34 例(17.44%)、耐甲氧西林葡萄球菌25例(12.82%)、铜绿假单胞菌13例(6.67%)、肺炎链球菌13例(6.67%)；入住重症监护室的COPD病人感染病原菌排在前三名的为耐甲氧西林葡萄球菌43例(21.29%)、流感嗜血杆菌14例(6.93%)、肺炎链球菌13例(6.44%)；LAMP对普通病房和ICU病房的COPD病人感染病原菌检测的灵敏度分别为78.95%、85.29%，特异度分别为58.52%、60.71%；与传统培养方法比较，铜绿假单胞菌的Kappa值最高，为0.87。结论LAMP对普通病房及重症监护室的COPD伴下呼吸道感染病原菌的检测均具有敏感、快速、经济有效的特点，能为临床治疗选用有效抗生素提供证据，对COPD伴下呼吸道感染的临床治疗具有重要意义。 |
| 英文摘要: |
| Objective To investigate the clinical application value of loop-mediated isothermal amplification technology (LAMP),namely, combined nucleic acid detection of respiratory pathogens (13 pairs), in the detection of pathogens of chronic obstructive pulmonary disease (COPD) with lower respiratory tract infection.Methods Three hundred and ninety-seven patients who were clinically diagnosed COPD with lower respiratory tract infection in Meizhou People's Hospital from January 2018 and December 2020 were collected. Among them, 195 cases were admitted to the general ward, and 202 cases needed ventilator assisted ventilation were admitted to the intensive care unit. Each patient collected sputum/BALF/bronchial aspirate for detection by using LAMP assay (13 pairs) and pathogen culture. The distribution characteristics of pathogenic bacteria detected by LAMP (13 pairs) in COPD patients with lower respiratory tract infection admitted to different wards for treatment were compared. The sensitivity and specificity of the LAMP assay (13 pairs)were calculated. The consistency of LAMP assay (13 pairs) and traditional culture detection results were statistically analyzed. The clinical value of LAMP assay (13 pairs) in detecting the pathogenic bacteria of COPD with lower respiratory tract infection were explored.Results The positive rates of LAMP for COPD with lower respiratory tract infection in general ward and ICU were 45.13% and 47.03%, respectively, which were significantly higher than those with traditional culture methods. The difference was statistically significant(P<0.05). According to LAMP detection results, the top three pathogenic bacteria in COPD patients admitted to the general ward were 34 cases of Haemophilus influenzae (17.44%), 25 cases of methicillin-resistant Staphylococcus (12.82%), 13 cases of Pseudomonas aeruginosa (6.67%), and 13 cases of Streptococcus pneumoniae (6.67%). The top three pathogens of COPD patients admitted to the ICU were 43 cases of methicillin-resistant Staphylococcus (21.29%), 14 cases of Haemophilus influenzae (6.93%) and 13 cases of Streptococcus pneumoniae (6.44%). The sensitivity of LAMP assay were 78.95% and 85.29%, and the specificity of LAMP assay were 58.52% and 60.71% in the general ward and ICU. Compared with the traditional culture method, the Kappa value of Pseudomonas aeruginosa(PAE) was the highest, which was 0.87.Conclusion LAMP assay has the characteristics of a sensitive, rapid, economic and effective for the common pathogenic bacteria of the patients diagnosed COPD with lower respiratory tract infection in the general ward and ICU, which can provide evidence for the selection of effective antibiotics for clinical treatment, and is of great significance for the clinical treatment of COPD patients with lower respiratory tract infection. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
