Ngwa Agha Ọhụrụ Maka Nchọpụta Ọrịa Ụkwara na Nchọpụta Mgbochi Ọgwụ: Usoro Ezubere Maka Ọgbọ Ọhụrụ (tNGS) Ejikọtara Ya na Mmụta Igwe Maka Nchọpụta Mmetụta Ụkwara Ụkwara.
Akụkọ akwụkwọ: CCa: ihe nlereanya nchọpụta dabere na tNGS na mmụta igwe, nke dabara adaba maka ndị nwere obere ụkwara nta na meningitis ụkwara nta.
Aha edemede: Usoro nhazi ọgbọ ọhụrụ nke metụtara ụkwara nta na mmụta igwe: usoro nchọpụta dị oke mkpa maka tuberculous pulmonary tubular na tuber meningitis.
Oge: 《Clinica Chimica Acta》
Ọ BỤRỤ: 6.5
Ụbọchị e bipụtara ya: Jenụwarị 2024
N'ịjikọta ya na Mahadum nke Chinese Academy of Sciences na Beijing Chest Hospital nke Capital Medical University, Macro & Micro-Test guzobere ụdị nchọpụta ụkwara nta dabere na ọgbọ ọhụrụ nke teknụzụ nhazi ezubere iche (tNGS) na usoro mmụta igwe, nke nyere mmetụta nchọpụta dị elu maka ụkwara nta nwere obere nje bacteria na meningitis tuberculous, nyere usoro nchọpụta hypersensitivity ọhụrụ maka nchọpụta ọrịa nke ụdị ụkwara nta abụọ, ma nyere aka na nchọpụta ziri ezi, nchọpụta ọgwụ na ọgwụgwọ ụkwara nta. N'otu oge ahụ, achọpụtara na enwere ike iji cfDNA plasma onye ọrịa dị ka ụdị ihe nlele kwesịrị ekwesị maka nnwale ahụike na nchọpụta nke TBM.
N'ọmụmụ ihe a, e jiri ihe nlele plasma 227 na ihe nlele mmiri cerebrospinal guzobe otu abụọ nke ụlọọgwụ, ebe e jiri ihe nlele ndị otu nchọpụta ụlọọgwụ guzobe ụdị mmụta igwe nke nchọpụta ụkwara nta, e jirikwa ihe nlele ndị otu nchọpụta ahụike chọpụta ụdị nchọpụta ahụ. E buru ụzọ lekwasị anya na ihe nlele niile site na otu nyocha njide pụrụ iche maka ụkwara nta Mycobacterium. Mgbe ahụ, dabere na data usoro TB-tNGS, a na-eji ihe nlereanya osisi mkpebi eme nyocha ugboro ise na usoro ọzụzụ na nkwenye nke usoro nchọpụta ụlọọgwụ, a na-enwetakwa oke nchọpụta nke ihe nlele plasma na ihe nlele mmiri cerebrospinal. A na-ewebata oke enwetara n'ime usoro nnwale abụọ nke usoro nchọpụta ahụike maka nchọpụta, a na-enyochakwa arụmọrụ nchọpụta nke onye mmụta site na usoro ROC. N'ikpeazụ, enwetara ụdị nchọpụta nke ụkwara nta.
Foto nke 1 eserese atụmatụ nke imewe nyocha
Nsonaazụ: Dịka oke nkọwapụta nke ihe nlele CSF DNA (AUC = 0.974) na ihe nlele cfDNA plasma (AUC = 0.908) nke a chọpụtara n'ọmụmụ ihe a si dị, n'ime ihe nlele 227, mmetụta nke ihe nlele CSF bụ 97.01%, nkọwapụta ya bụ 95.65%, mmetụta na nkọwapụta nke ihe nlele plasma bụ 82.61% na 86.36%. Na nyocha nke ihe nlele 44 jikọtara ọnụ nke plasma cfDNA na cerebrospinal fluid DNA sitere na ndị ọrịa TBM, atụmatụ nchọpụta nke ọmụmụ a nwere nguzosi ike dị elu nke 90.91% (40/44) na plasma cfDNA na cerebrospinal fluid DNA, mmetụta ahụ bụkwa 95.45% (42/44). Na ụmụaka nwere ụkwara nta akpa ume, atụmatụ nchọpụta nke ọmụmụ a na-adị mfe karị maka ihe nlele plasma karịa nsonaazụ nchọpụta Xpert nke ihe nlele mmiri gastric sitere na otu ndị ọrịa ahụ (28.57% VS 15.38%).
Fig. 2. Nnyocha arụmọrụ nke ụdị nchọpụta ụkwara nta maka ihe nlele ọnụọgụgụ mmadụ.
Fig. 3 Nsonaazụ nchọpụta nke ihe atụ ejikọtara ọnụ
Mmechi: E guzobere usoro nchọpụta ọrịa ụkwara nta nke na-adịghị mma n'ọmụmụ ihe a, nke nwere ike inye ngwaọrụ nchọpụta nke nwere mmetụta kachasị elu maka ndị ọrịa nwere ụkwara nta oligobacillary (omenala na-adịghị mma). Nchọpụta nke ụkwara nta nke na-adịghị mma dabere na plasma cfDNA nwere ike ịbụ ụdị nlele kwesịrị ekwesị maka nchọpụta nke ụkwara nta na meningitis nke na-arụ ọrụ (ihe nlele plasma dị mfe ịnakọta karịa mmiri cerebrospinal maka ndị ọrịa a na-enyo enyo na ha nwere ụkwara nta ụbụrụ).
Njikọ mbụ: https://www.sciencedirect.com/science/article/pii/s0009898123004990? via%3Dihub
Okwu mmeghe dị mkpirikpi nke ngwaahịa nchọpụta usoro ụkwara nta Macro & Micro-Test
N'ihi ọnọdụ ihe nlele dị mgbagwoju anya nke ndị ọrịa ụkwara nta na mkpa dị iche iche, Macro & Micro-Test na-enye usoro zuru oke nke ngwọta NGS maka mwepụta liquefaction site na ihe nlele sputum, owuwu na usoro ọbá akwụkwọ Qualcomm, na nyocha data. Ngwaahịa ndị a na-ekpuchi nchọpụta ngwa ngwa nke ndị ọrịa ụkwara nta, nchọpụta ọgwụ mgbochi ụkwara nta, ụdị nke mycobacterium ụkwara nta na NTM, nchọpụta hypersensitivity nke nje bacteria-negative tuberculous na ndị nwere ụkwara nta, wdg.
Ngwa nchọpụta serial maka ụkwara nta na mycobacteria:
| Nọmba ihe | aha ngwaahịa | ọdịnaya nnwale ngwaahịa | ụdị ihe nlele | ụdị dị mkpa |
| HWTS-3012 | Onye na-ewepụta ihe nlele | Ejiri ya na ọgwụgwọ mmiri ara ehi nke ihe nlele sputum, enwetala nọmba ndekọ klas mbụ, Sutong Machinery Equipment 20230047. | afụ | |
| HWTS-NGS-P00021 | Ngwa nchọpụta ọnụọgụ Qualcomm maka ụkwara nta na-adịghị mma (usoro njide nyocha) | Nchọpụta mmetụta uche na-adịghị emerụ ahụ (mmiri mmiri biopsy) maka ụkwara nta akpa ume na eriri afọ na-adịghị mma nke nje bacteria; E jiri usoro metagenomics dị elu nyochaa ihe nlele nke ndị a na-enyo enyo na ha bu ọrịa ụkwara nta ma ọ bụ mycobacteria na-abụghị ụkwara nta, ma nye ozi nchọpụta nke ma ụkwara nta ma ọ bụ mycobacteria na-abụghị ụkwara nta bu ọrịa ahụ, e nyekwara ozi bụ isi gbasara mgbochi ọgwụ nke ụkwara nta mycobacterium. | Ọbara dị n'akụkụ, mmiri ịsa ahụ alveolar, hydrothorax na ascites, ihe nlele ntụpọ, mmiri cerebrospinal. | Ọgbọ nke abụọ |
| HWTS-NGS-T001 | Ngwa nchọpụta ụdị Mycobacterium na ọgwụ mgbochi (usoro nhazi usoro mmụba ọtụtụ) | Nnwale ụdị Mycobacterium, gụnyere MTBC na 187 NTM；Nchọpụta nke ụkwara nta Mycobacterium na-eguzogide ọgwụ na-ekpuchi ọgwụ iri na atọ na ebe mgbanwe 16 nke mkpụrụ ndụ ihe nketa na-eguzogide ọgwụ. | Agụụ, mmiri ịsa ahụ alveolar, hydrothorax na ascites, ihe nlele ntụpọ, mmiri cerebrospinal. | Ikpo okwu abụọ nke ọgbọ nke abụọ/nke atọ |
Isi ihe dị mkpa: Ngwa nchọpụta ụdị nje bacteria HWTS-NGS-T001 na ọgwụ mgbochi ọgwụ (usoro mmụba ọtụtụ)
Okwu mmeghe ngwaahịa
Ngwaahịa a dabere na ọgwụ mbụ na nke abụọ nke a kọwara na ntuziaka ọgwụgwọ TB nke WHO, macrolides na aminoglycosides a na-ejikarị na ntuziaka ọgwụgwọ NTM, ebe ndị na-eguzogide ọgwụ na-ekpuchi otu ìgwè ebe niile metụtara iguzogide ọgwụ na katalọgụ mgbanwe nke WHO Mycobacterium tuberculosis complex, yana mkpụrụ ndụ ihe nketa ndị ọzọ akọpụtara na ebe mgbanwe ọgwụ dịka nyocha na ọnụ ọgụgụ nke akwụkwọ ndị nwere akara dị elu n'ụlọ na mba ofesi si dị.
Nchọpụta ụdị NTM dabere na ụdị NTM a chịkọtara na ntuziaka NTM nke akwụkwọ akụkọ China Journal of Tuberculosis and Respiratory Diseases bipụtara na nkwenye nke ndị ọkachamara. Ihe ndị e mere maka ụdị ụdị NTM nwere ike ime ka ihe karịrị ụdị NTM 190 dịkwuo elu, hazie ma depụta ha.
Site na teknụzụ njikọta PCR multiplex ezubere iche, mkpụrụ ndụ ihe nketa genotyping na mkpụrụ ndụ ihe nketa na-eguzogide ọgwụ nke Mycobacterium mụbara site na iji multiplex PCR, e wee nweta njikọta amplicon nke mkpụrụ ndụ ihe nketa ebumnuche a ga-achọpụta. Enwere ike ịmepụta ngwaahịa ndị a mụbara n'ime ọbá akwụkwọ nhazi usoro nke ọgbọ nke abụọ ma ọ bụ ọgbọ nke atọ, a pụkwara itinye ikpo okwu nhazi usoro nke ọgbọ nke abụọ na ọgbọ nke atọ n'usoro dị elu iji nweta ozi usoro nke mkpụrụ ndụ ihe nketa ebumnuche. Site na iji ya tụnyere mgbanwe ndị a maara dị na nchekwa data ntụaka arụnyere n'ime (gụnyere katalọgụ mgbanwe ụkwara nta Mycobacterium nke WHO na mmekọrịta ya na iguzogide ọgwụ), achọpụtara mgbanwe ndị metụtara iguzogide ọgwụ ma ọ bụ nnabata nke ọgwụ mgbochi ụkwara nta. Tinyere ngwọta ọgwụgwọ sputum sample nke Macro & Micro-Test nke meghere onwe ya, edoziri nsogbu nke obere arụmọrụ mmụba nucleic acid nke ihe nlele sputum ahụike (ugboro iri karịa nke usoro ọdịnala), ka enwere ike itinye nchọpụta nhazi iguzogide ọgwụ ozugbo na ihe nlele sputum ahụike.
Oke nchọpụta ngwaahịa
34mkpụrụ ndụ ihe nketa metụtara iguzogide ọgwụ ọjọọ nke18ọgwụ mgbochi ụkwara nta na6Achọpụtara ọgwụ NTM, na-ekpuchi ha297ebe ọgwụ na-anaghị eguzogide ọgwụ; Ụdị ụkwara nta Mycobacterium iri na ihe karịrị ya190A chọpụtara ụdị NTM dị iche iche.
Tebụl 1: Ozi gbasara ọgwụ 18+6 +190+NTM
Uru ngwaahịa
Ike ime mgbanwe siri ike n'ụlọọgwụ: enwere ike ịchọpụta ihe nlele sputum ozugbo site na iji ihe na-enye onwe ya mmiri na-enweghị ọdịbendị.
Ọrụ nnwale ahụ dị mfe: agba nke mbụ nke ọrụ mmụba dị mfe, a na-arụkwa ọrụ ọbá akwụkwọ n'ime awa atọ, nke na-eme ka arụmọrụ ọrụ ka mma.
Ide ihe zuru oke na iguzogide ọgwụ: ikpuchi ebe MTB na NTM na-eguzogide ọgwụ na ebe ndị na-anaghị anabata ọgwụ, nke bụ isi ihe na-echegbu ahụike, ide ihe ziri ezi na nchọpụta iguzogide ọgwụ, ịkwado ngwanrọ nyocha onwe onye, na ịmepụta akụkọ nyocha na otu pịa.
Ndakọrịta: ndakọrịta ngwaahịa, imeghari na nyiwe ILM na MGI/ONT bụ isi.
Nkọwapụta ngwaahịa
| Koodu ngwaahịa | aha ngwaahịa | Ikpo okwu nchọpụta | nkọwapụta |
| HWTS-NGS-T001 | Ngwa nchọpụta ụdị Mycobacterium na ọgwụ mgbochi (usoro mmụba ọtụtụ) | ONT, Illumina, MGI, Salus pro | 16/96rxn |
Oge ozi: Jenụwarị-23-2024