He Patu Hou mō te Tātaritanga o te Mate Kohi me te Kitenga i te Ātete Rongoā: He Raupapa Whaiaro o te Reanga Hou (tNGS) i Whakakotahitia me te Ako Mīhini mō te Tātaritanga o te Mate Kohi i te Tairongo Nui
Pūrongo tuhinga: CCa: he tauira tātaritanga e ahu mai ana i te tNGS me te ako mīhini, e tika ana mō te hunga he iti ake te mate kohi kitakita me te meningitis kohi.
Taitara o te tuhinga: Te raupapatanga o te whakatupuranga hou e aro ana ki te kohi me te ako mīhini: he rautaki tātaritanga tino tairongo mō ngā ngongo pūkahukahu ngoikore me te meningitis ngongo.
Wāhanga: 《Clinica Chimica Acta》
MĒNĀ：6.5
Te rā i whakaputaina ai: Hanuere 2024
I te taha o te Whare Wānanga o ngā Pūtaiao Hainamana me te Hōhipera Chest o te Whare Wānanga Hauora o Capital o Beijing, i whakatūria e Macro & Micro-Test tētahi tauira tātaritanga mate kohi i runga i te whakatupuranga hou o te hangarau raupapatanga whai take (tNGS) me te tikanga ako mīhini, i whakarato i te aro nui ki te kimi i te mate kohi me te iti o ngā huakita me te meningitis kohi, i whakarato i tētahi tikanga tātaritanga mate pāwera hou mō te tātaritanga haumanu o ngā momo mate kohi e rua, ā, i āwhina i te tātaritanga tika, te kimi ātete rongoā me te maimoatanga o te mate kohi. I taua wā anō, i kitea ka taea te whakamahi i te cfDNA plasma o te tūroro hei momo tauira e tika ana mō te tauira haumanu i roto i te tātaritanga o te TBM.
I roto i tēnei rangahau, e 227 ngā tauira plasma me ngā tauira wai cerebrospinal i whakamahia hei whakatū i ngā rōpū haumanu e rua, i whakamahia ai ngā tauira rōpū tātaritanga taiwhanga hei whakatū i te tauira ako mīhini mō te tātaritanga mate kohi, ā, i whakamahia ngā tauira rōpū tātaritanga haumanu hei manatoko i te tauira tātaritanga kua whakatūria. I arohia tuatahitia ngā tauira katoa e tētahi puna tirotiro hopu kua whakaritea mō te Mycobacterium tuberculosis. Kātahi, i runga i ngā raraunga raupapatanga TB-tNGS, ka whakamahia te tauira rākau whakatau hei mahi i te whakamana whakawhiti-5-wā i runga i ngā huinga whakangungu me te whakamana o te rarangi tātaritanga taiwhanga, ā, ka whiwhihia ngā paepae tātaritanga o ngā tauira plasma me ngā tauira wai cerebrospinal. Ka kawea te paepae kua whiwhihia ki roto i ngā huinga whakamātautau e rua o te rarangi tātaritanga haumanu hei kimi, ā, ka aromatawaihia te mahi tātaritanga o te ākonga e te pihi ROC. Hei whakamutunga, ka whiwhihia te tauira tātaritanga o te mate kohi.
Pikitia 1 hoahoa kauwhata o te hoahoa rangahau
Ngā Hua: E ai ki ngā paepae motuhake o te tauira DNA CSF (AUC = 0.974) me te tauira cfDNA plasma (AUC = 0.908) i whakatauhia i roto i tēnei rangahau, i roto i ngā tauira 227, ko te aro o te tauira CSF he 97.01%, ko te motuhaketanga he 95.65%, ā, ko te aro me te motuhaketanga o te tauira plasma he 82.61% me te 86.36%. I roto i te tātaritanga o ngā tauira takirua 44 o te cfDNA plasma me te DNA wai cerebrospinal mai i ngā tūroro TBM, he rite tonu te rautaki tātaritanga o tēnei rangahau ki te 90.91% (40/44) i roto i te cfDNA plasma me te DNA wai cerebrospinal, ā, ko te aro he 95.45% (42/44). I roto i ngā tamariki e pangia ana e te mate kohi pūkahukahu, he aro ake te rautaki tātaritanga o tēnei rangahau ki ngā tauira plasma i ngā hua kitenga Xpert o ngā tauira wai puku mai i ngā tūroro kotahi (28.57% VS 15.38%).
Pikitia 2 Te mahi tātaritanga o te tauira tātaritanga mate kohi mō ngā tauira taupori
Pikitia 3 Ngā hua tātaritanga o ngā tauira takirua
Whakatau: I whakatūria he tikanga tātaritanga tairongo nui mō te mate kohi i roto i tēnei rangahau, ka taea te whakarato i tētahi taputapu tātaritanga me te tairongo teitei rawa atu mō ngā tūroro haumanu me te mate kohi oligobacillary (ahurea kino). Ko te kitenga o te mate kohi tairongo nui i runga i te cfDNA plasma he momo tauira pai pea mō te tātaritanga o te mate kohi hohe me te meningitis kohi (he māmā ake te kohikohi i ngā tauira plasma i te wai cerebrospinal mō ngā tūroro e whakapaetia ana he mate kohi roro).
Hononga taketake: https://www.sciencedirect.com/science/article/pii/s0009898123004990? mā%3Dihub
He kupu whakataki poto mō ngā hua kimi raupapa mate kohi Macro & Micro-Test
I runga i te āhua uaua o ngā tauira o ngā tūroro kohi me ngā hiahia maha, ka whakaratohia e Macro & Micro-Test he huinga katoa o ngā otinga NGS mō te tango wai mai i ngā tauira huware, te hanga whare pukapuka Qualcomm me te raupapatanga, me te tātari raraunga. Kei roto i ngā hua te tātaritanga tere o ngā tūroro kohi, te kimi ātete rongoā o te kohi, te momo o te mycobacterium tuberculosis me te NTM, te tātaritanga mate pāwera o te kohi huakita-kore me te hunga kohi, me ētahi atu.
Ngā kete kimi raupapa mō te mate kohi me te mycobacteria:
| Tau Nama | ingoa hua | ihirangi whakamātautau hua | momo tauira | tauira e tika ana |
| HWTS-3012 | Kaihoko tuku tauira | I whakamahia hei rongoā wai mō ngā tauira huware, ā, kua whiwhi i te nama rekoata tuatahi, Sutong Machinery Equipment 20230047. | huware | |
| HWTS-NGS-P00021 | Kete kimi rahinga Qualcomm mō te mate kohi tairongo nui (tikanga hopu tirotiro) | Te kimi i te mate pāwera kore-whakaeke (koiora wai) mō te mate kohi pūkahukahu me ngā pona roro kāore he huakita; I tātarihia ngā tauira o te hunga i whakapaetia kua pangia e te mate kohi, te mate kohi rānei ehara i te mate kohi mā te tātaritanga hohonu o te metagenomics, ā, i whakaratohia ngā mōhiohio kitenga mēnā i pangia e te mate kohi, te mate kohi rānei ehara i te mate kohi, me ngā mōhiohio ātete rongoā matua o te mate kohi. | Toto ā-taha, wai horoi alveolar, hydrothorax me ascites, tauira poka arotahi, wai cerebrospinal. | Te whakatupuranga tuarua |
| HWTS-NGS-T001 | Kete kimi ātete me te pato i te Mycobacterium (tikanga raupapatanga whakarea maha) | Whakamātautau momo Mycobacterium, tae atu ki te MTBC me te 187 NTM；Ko te kitenga o te Mycobacterium tuberculosis i te ātete rongoā e kapi ana i te 13 rongoā me te 16 ngā pae whakarerekētanga matua o ngā ira ātete rongoā. | Hupa, wai horoi alveolar, hydrothorax me ascites, tauira poka arotahi, wai cerebrospinal. | Pūhara takirua o te whakatupuranga tuarua/tuatoru |
Ngā mea nui: Kete kimi ātete me te patopato Mycobacterium HWTS-NGS-T001 (tikanga whakanui maha)
Whakataki hua
Ko te hua e hangai ana i ngā rongoā matua o te rārangi tuatahi me te tuarua kua whakaahuatia i roto i ngā aratohu maimoatanga TB a te WHO, ngā macrolides me ngā aminoglycosides e whakamahia whānuitia ana i roto i ngā aratohu maimoatanga NTM, ā, ko ngā pae ātete rongoā e kapi ana i te rōpū kotahi o ngā pae e pā ana ki te ātete rongoā i roto i te rārangi whakarerekētanga matatini Mycobacterium tuberculosis a te WHO, me ētahi atu ira ātete rongoā me ngā pae whakarerekētanga kua pūrongohia e ai ki te rangahau me ngā tatauranga o ngā tuhinga kaute teitei i te kāinga me tāwāhi.
Ko te tautuhi momo i ahu mai i ngā momo NTM kua whakarāpopototia i roto i ngā aratohu NTM i whakaputaina e te Chinese Journal of Tuberculosis and Respiratory Diseases me te whakaae a ngā tohunga. Ka taea e ngā paraime momo kua hoahoatia te whakanui, te raupapa me te tāpiri i ngā tohu ki ngā momo NTM neke atu i te 190.
Mā te hangarau whakanui PCR maha-whakaaro, i whakanuia ngā ira whakaingoa me ngā ira ātete-rongoā o Mycobacterium mā te PCR maha-whakaaro, ā, i whiwhihia te huinga amplicon o ngā ira ūnga kia kitea. Ka taea te hanga i ngā hua whakanuia ki roto i ngā whare pukapuka raupapatanga tere-whakaputa o te whakatupuranga tuarua, tuatoru rānei, ā, ka taea te whakamahi i ngā tūāpapa raupapatanga o te whakatupuranga tuarua me te tuatoru ki te raupapatanga hohonu hei tiki i ngā mōhiohio raupapatanga o ngā ira ūnga. Mā te whakataurite ki ngā whakarerekētanga e mōhiotia ana kei roto i te pātengi raraunga tohutoro kua hangaia (tae atu ki te rārangi whakarerekētanga matatini WHO Mycobacterium tuberculosis me tōna whanaungatanga ki te ātete rongoā), i whakatauhia ngā whakarerekētanga e pā ana ki te ātete rongoā, te ngoikore rānei o ngā rongoā anti-tuberculosis. I te whakakotahitanga me te otinga maimoatanga tauira huware tuwhera-ake o Macro & Micro-Test, i whakatauhia te raruraru o te iti o te whai huatanga whakanui waikawa karihi o ngā tauira huware haumanu (tekau ngā wā teitei ake i ngā tikanga tuku iho), kia taea ai te whakamahi tika i te kitenga raupapatanga ātete rongoā ki ngā tauira huware haumanu.
Awhe kimi hua
34ngā ira e pā ana ki te ātete rongoā o18ngā rongoā ārai mate kohi me6I kitea ngā rongoā NTM, e kapi ana i297ngā wāhi ātete rongoā; Tekau ngā momo Mycobacterium tuberculosis me te neke atu i te190i kitea ngā momo NTM.
Ripanga 1: Ngā Mōhiotanga mō ngā Rongoā 18+6 +190+NTM
Painga hua
He kaha te urutau haumanu: ka taea te kimi tika i ngā tauira huware mā te whakamahi i te kaihoko wai-ake, me te kore he ahurea.
He māmā noa te mahi whakamātautau: he māmā noa te wāhanga tuatahi o te mahi whakanui, ā, ka oti te hanganga whare pukapuka i roto i ngā hāora e 3, ka pai ake te whai huatanga o te mahi.
Te pato whānui me te ātete rongoā: e kapi ana i ngā pae ātete pato me te rongoā o te MTB me te NTM, arā, ngā kaupapa matua o te āwangawanga haumanu, te kimi pato tika me te ātete rongoā, te tautoko i te pūmanawa tātari motuhake, me te whakaputa pūrongo tātari mā te pāwhiri kotahi.
Hototahi: hototahitanga o ngā hua, urutau ki ngā tūāpapa matua o te ILM me te MGI/ONT.
Ngā whakatakotoranga hua
| Waehere hua | ingoa hua | Pūhara kimi | ngā whakaritenga |
| HWTS-NGS-T001 | Kete kimi ātete me te pato i te Mycobacterium (tikanga whakanui maha) | ONT, Illumina, MGI, Salus pro | 16/96 rxn |
Wā tuku: Hanuere-23-2024