摘要
目的:通过回顾性分析14例经宏基因组二代测序(metagenomics next generation sequencing,mNGS)技术确诊侵袭性真菌性鼻窦炎(invasive fungal rhinosinusitis,IFRS)患者的临床资料,探讨mNGS技术在快速确诊IFRS中的应用价值。方法:回顾性分析天津市第一中心医院2021年2月至2023年10月期间收治的14例IFRS患者的临床资料,其中男性8例,女性6例,年龄14~77岁。所有患者均通过鼻腔鼻窦病变活检标本mNGS测序技术确诊IFRS,对其实验室检查、影像学检查、组织病理学检查结果,以及治疗方案和预后情况等临床资料进行总结分析。结果:14例患者均确诊为IFRS,其中根霉属7例,曲霉属5例,木霉菌属1例,赛多孢子菌属1例。随访时间2个月至2年,截至随访结束,14例IFRS患者中11例痊愈,未见复发迹象,3例患者术后症状明显改善。结论:mNGS测序技术可作为快速诊断IFRS的检测手段,为IFRS的临床诊疗提供病原学依据,具有良好的临床应用价值。
Objective By conducting a retrospective analysis of the clinical data of 14 patients diagnosed with invasive fungal rhinosinusitis(IFRS)confirmed by metagenomics next generation sequencing(mNGS)technology,we aim to explore the rapid diagnosis value of mNGS in IFRS.Methods The clinical data of 14 IFRS patients admitted to TianJin First Central Hospital were retrospectively analyzed from February 2021 to October 2023.The study cohort comprised 8 males and 6 females,with ages ranging from 14 to 77 years.All patients were diagnosed as IFRS by performing mNGS sequencing technology of nasal sinus lesion biopsy specimens.Clinical data such as laboratory examination,imaging examination,histopathological examination results,treatment plan and prognosis were summarized and analyzed.Results All 14 patients were diagnosed as IFRS,with mNGS detecting pathogens such as Rhizopus(7 cases),Aspergillus(5 cases),Trichoderma(1 case),and Scedosporium apiospermum(1 case).Follow-up evaluations were conducted for a period ranging from 2 months to 2 years post-treatment.At the end of follow-up,11 out of 14 IFRS patients achieved a complete cure with no signs of recurrence,while the symptoms of the remaining 3 patients significantly improved with comprehensive treatment.Conclusion mNGS emerges as a highly effective diagnostic tool for IFRS,providing valuable microbiological evidence for clinical diagnosis and demonstrating promising clinical utility.
作者
张晨婷
梁毅博
只璟泰
赵亮
林鹏
王巍
张桂敏
Zhang Chenting;Liang Yibo;Zhi Jingtai;Zhao Liang;Lin Peng;Wang Wei;Zhang Guimin(Department of Otorhinolaryngology Head and Neck Surgery,Tianjin First Central Hospital,Institute of Otolaryngology of Tianjin,Key Medical Discipline of Tianjin(Otolaryngology),Quality Control Centre of Otolaryngology,Tianjin 300192,China;The First Central Clinical School,Tianjin Medical University,Tianjin 300070,China;TianJin Medical University Eye Hospital,Tianjin 300384,China)
出处
《中华耳鼻咽喉头颈外科杂志》
CSCD
北大核心
2024年第5期464-471,共8页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
基金
天津市医学重点学科项目(TJYXZDXK-046A)
津门医学英才项目(TJSJMYXYC-D2-021)
外泌体基因多态性与过敏性鼻炎关系的研究(TJWJ2022XK020)。
关键词
鼻窦炎
真菌
宏基因组二代测序
诊断
Sinusitis
Fungi
Metagenomics next generation sequencing
Diagnosis
