天津医药

天津医药 ›› 2019, Vol. 47 ›› Issue (4): 368-370.doi: 10.11958/20190835

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诊断性介入肺脏病学取材联合病原微生物宏基因组测序在肺部感染应用的原则

吴波 1，冯靖 2△，张静 3，王家卉 2   

  1. 1无锡市人民医院移植科（邮编214023）；2天津医科大学总医院呼吸与危重症医学科；3复旦大学附属上海中山医院呼吸与危 重症医学科
  • 收稿日期:2019-03-20 修回日期:2019-04-01 出版日期:2019-04-15 发布日期:2019-05-27
  • 通讯作者: 冯靖 E-mail:zyyhxkfj@126.com
  • 作者简介:吴波（1969），男，博士，主任医师，主要从事感染与呼吸危重症方面研究
  • 基金资助:
    国家自然科学基金资助项目;国家自然科学基金资助项目;国家自然科学基金资助项目;十三五国家科技部支撑计划课题

Principles for the application of diagnostic interventional pulmonology combined with pathogenic microbial metagenomics sequencing in pulmonary infection

WU Bo1, FENG Jing2△, ZHANG Jing3, WANG Jia-hui2   

  1. 1 Department of Transplantation, Wuxi People’s Hospital, Wuxi 214023, China; 2 Department of Respiratory and Critical Care Medicine, Tianjin Medical University General Hospital; 3 Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital Affiliated to Fudan University
  • Received:2019-03-20 Revised:2019-04-01 Published:2019-04-15 Online:2019-05-27
  • Contact: FENG Jing E-mail:zyyhxkfj@126.com

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摘要： 肺部感染是常见的感染之一，病情在短时间内进展较快，如不采取有效治疗，可危及生命。本文就诊断性 介入肺脏病学取材联合病原微生物宏基因组测序技术（dIP+mMS）在肺部感染应用的原则做以下解释。包括 dIP+ mMS的适应证、常用取材方式、不同取材方式的合理选择及封装、支气管镜的选择、引导内镜技术和快速现场评价 （ROSE）的辅助使用等。此外，获取标本后应分别提取遗传物质，合并上机测序（鸡尾酒方式）；还应注意全身和局部 抗菌药物的应用及不同取材部位对检测结果的影响。

关键词: 肺疾病, 诊断, 呼吸道感染, 诊断性介入肺脏病学, 微生物宏基因组测序

Abstract: Pulmonary infection is one of the common infections, and the condition progresses faster in a short time. It can be life-threatening if the infection is not treated effectively. This article explains the application principles of diagnostic interventional pulmonology combined with microbial metagenomics sequencing (dIP+mMS) in pulmonary infection, including indications of dIP + mMS, common sampling methods, reasonable choices of different sampling methods and packaging methods, the selection of bronchoscopy, guided endoscopic technique and rapid on site evaluation (ROSE). In addition, the genetic materials should be extracted separately after obtaining the specimen, and sequenced together (cocktail method). Attention should also be paid to the application of systemic and local antimicrobial agents and the effects of different sampling sites on the result of dIP+mMS.

Key words: lung diseases, diagnosis, respiratory tract infections, diagnostic interventional pulmonology, microbial metagenomics sequencing