Sabuwar Makami Don Gano Tarin Fuka Da Gano Juriya Daga Magunguna: Sabuwar Tsari Mai Nuni (tNGS) Tare da Koyon Inji Don Gano Tarin Fuka Mai Sauƙi
Rahoton Adabi: CCa: samfurin ganewar asali bisa ga tNGS da koyon na'ura, wanda ya dace da mutanen da ke fama da tarin fuka mai ƙarancin ƙwayoyin cuta da kuma meningitis na tarin fuka.
Taken Takardar Karatu: Tsarin tsarawa da koyon injin da aka yi niyya ga tarin fuka: wata dabarar ganewar asali mai matuƙar tasiri ga bututun huhu da kuma meningitis na bututu.
Na lokaci-lokaci: 《Clinica Chimica Acta》
IDAN: 6.5
Ranar bugawa: Janairu 2024
Tare da haɗin gwiwar Jami'ar Kwalejin Kimiyya ta China da Asibitin Chest na Beijing na Jami'ar Capital Medical, Macro & Micro-Test sun kafa wani samfurin gano cutar tarin fuka bisa ga sabuwar hanyar fasahar da aka yi niyya (tNGS) da kuma hanyar koyon na'ura, wanda ya samar da yanayin gano cutar tarin fuka mai ƙarancin ƙwayoyin cuta da ciwon daji, ya samar da sabuwar hanyar gano cutar tarin fuka don gano nau'ikan tarin fuka guda biyu, kuma ya taimaka wajen gano cutar daidai, gano juriya ga magunguna da kuma magance cutar tarin fuka. A lokaci guda, an gano cewa ana iya amfani da cfDNA na plasma na majiyyaci a matsayin samfurin da ya dace don ɗaukar samfurin asibiti a lokacin gano cutar TBM.
A cikin wannan binciken, an yi amfani da samfuran plasma guda 227 da samfuran ruwan cerebrospinal don kafa ƙungiyoyi biyu na asibiti, inda aka yi amfani da samfuran ƙungiyar binciken dakin gwaje-gwaje don kafa tsarin koyon injin na gano tarin fuka, kuma an yi amfani da samfuran ƙungiyar binciken asibiti don tabbatar da samfurin ganewar asali da aka kafa. An fara kai hari ga duk samfuran ta hanyar wani wurin binciken kamawa na musamman da aka tsara don tarin fuka na Mycobacterium. Sannan, bisa ga bayanan jerin TB-tNGS, ana amfani da samfurin bishiyar yanke shawara don yin tantancewa sau 5 akan jerin horo da tabbatarwa na layin ganewar asibiti, kuma ana samun matakan ganewar samfuran plasma da samfuran ruwan cerebrospinal. An kawo matakin da aka samu cikin jerin gwaji guda biyu na layin ganewar asibiti don ganowa, kuma ana kimanta aikin ganewar wanda ya koyi ta hanyar lanƙwasa ROC. A ƙarshe, an sami samfurin ganewar cutar tarin fuka.
Hoto na 1 zane mai zane na ƙirar bincike
Sakamako: Dangane da takamaiman matakin samfurin CSF DNA (AUC = 0.974) da samfurin cfDNA na plasma (AUC = 0.908) da aka ƙayyade a cikin wannan binciken, daga cikin samfuran 227, ƙarfin samfurin CSF shine 97.01%, takamaiman shine 95.65%, kuma ƙarfin samfurin plasma shine 82.61% da 86.36%. A cikin nazarin samfuran cfDNA na plasma guda 44 da aka haɗa da jini da kuma DNA na cerebrospinal daga marasa lafiya na TBM, dabarun ganewar wannan binciken yana da babban daidaito na 90.91% (40/44) a cikin cfDNA na plasma da kuma cerebrospinal fluid DNA, kuma ƙarfin shine 95.45% (42/44). A cikin yara masu fama da tarin fuka na huhu, dabarun ganewar wannan binciken ya fi saurin kamuwa da samfuran plasma fiye da sakamakon gano Xpert na samfuran ruwan ciki daga marasa lafiya iri ɗaya (28.57% VS 15.38%).
Hoto na 2. Binciken aikin samfurin gano cutar tarin fuka don samfuran yawan jama'a
Hoto na 3 Sakamakon ganewar asali na samfuran da aka haɗa
Kammalawa: An kafa wata hanyar gano cutar tarin fuka mai saurin kamuwa da cuta a cikin wannan binciken, wadda za ta iya samar da kayan aikin gano cutar tare da mafi girman saurin kamuwa da cutar ga marasa lafiya da ke fama da cutar tarin fuka ta oligobacillary (cututtukan da ba su da kyau). Gano cutar tarin fuka mai saurin kamuwa da cuta bisa ga plasma cfDNA na iya zama nau'in samfurin da ya dace don gano cutar tarin fuka mai aiki da kuma meningitis mai kama da cutar tarin fuka (samfuran plasma sun fi sauƙin tattarawa fiye da ruwan cerebrospinal ga marasa lafiya da ake zargi da cutar tarin fuka ta kwakwalwa).
Asalin hanyar haɗi: https://www.sciencedirect.com/science/article/pii/s0009898123004990? via%3Dihub
Gabatarwa ta taƙaitaccen bayani game da samfuran gano tarin fuka na Macro & Micro-Test
Ganin yanayin samfurin masu fama da tarin fuka mai sarkakiya da buƙatu daban-daban, Macro & Micro-Test yana ba da cikakken tsarin mafita na NGS don cire ruwa daga samfuran maniyyi, gina da tsara ɗakin karatu na Qualcomm, da kuma nazarin bayanai. Kayayyakin sun haɗa da gano masu fama da tarin fuka cikin sauri, gano cutar tarin fuka mai jure wa magani, nau'in cutar tarin fuka ta mycobacterium da NTM, gano cutar tarin fuka mai kama da bakteriya da kuma mutanen da ke da tarin fuka, da sauransu.
Kayan gano tarin fuka da ƙwayoyin cuta na mycobacteria:
| Lambar Abu | sunan samfurin | Abubuwan gwajin samfura | nau'in samfurin | samfurin da ya dace |
| HWTS-3012 | Wakilin sakin samfurin | An yi amfani da shi wajen maganin shan ƙwayoyin maniyyi, kuma ya sami lambar rikodin aji na farko, Sutong Machinery Equipment 20230047. | man shafawa | |
| HWTS-NGS-P00021 | Kit ɗin gano adadi na Qualcomm don tarin fuka mai saurin amsawa (hanyar kama bincike) | Gano rashin lafiyar da ba ta da haɗari (ruwa biopsy) ga tarin fuka na huhu da ƙusoshin kwakwalwa; An yi nazarin samfuran mutanen da ake zargin sun kamu da tarin fuka ko mycobacteria marasa tarin fuka ta hanyar amfani da metagenomics mai zurfi, kuma an ba da bayanan gano ko tarin fuka ko mycobacteria marasa tarin fuka sun kamu da cutar, kuma an ba da manyan bayanai game da juriyar magunguna na tarin fuka na mycobacterium. | Jinin gefe, ruwan wankewar alveolar, hydrothorax da ascites, samfurin huda hankali, ruwan cerebrospinal. | Tsarin ƙarni na biyu |
| HWTS-NGS-T001 | Kayan aikin gano nau'in Mycobacterium da kuma maganin juriya ga magunguna (hanyar tsara yawan ƙarawa) | Gwajin buga Mycobacterium, gami da MTBC da 187 NTM；Gano juriyar magunguna na tarin fuka na Mycobacterium ya ƙunshi magunguna 13 da kuma wurare 16 na maye gurbi na kwayoyin halittar da ke jure wa magani. | Maniyyi, ruwan wankewar alveolar, hydrothorax da ascites, samfurin hudawa, ruwan cerebrospinal. | Dandalin dandamali biyu na ƙarni na biyu/na uku |
Muhimman bayanai: Kayan aikin HWTS-NGS-T001 na buga Mycobacterium da kuma kayan aikin gano juriya ga magunguna (hanyar ƙara yawan aiki)
Gabatarwar samfur
Samfurin ya dogara ne akan manyan magunguna na farko da na biyu da aka bayyana a cikin jagororin maganin tarin fuka na WHO, macrolides da aminoglycosides waɗanda aka saba amfani da su a cikin jagororin maganin NTM, kuma wuraren da ke jure wa magunguna sun ƙunshi dukkan rukunin wurare guda ɗaya da ke da alaƙa da juriyar magani a cikin kundin sauye-sauyen tarin fuka na WHO Mycobacterium, da kuma sauran kwayoyin halittar da aka ruwaito na juriyar magani da wuraren maye gurbi bisa ga bincike da ƙididdiga na wallafe-wallafen da suka nuna sakamako mai kyau a gida da waje.
Gano nau'in NTM ya dogara ne akan nau'ikan NTM da aka taƙaita a cikin jagororin NTM da mujallar Sinanci ta buga game da cututtukan tarin fuka da numfashi da kuma amincewar ƙwararru. Tsarin firam ɗin bugawa da aka tsara na iya faɗaɗa, tsarawa da kuma yin bayani game da nau'ikan NTM sama da 190.
Ta hanyar fasahar ƙara yawan ƙwayoyin cuta ta PCR da aka yi niyya, an ƙara yawan ƙwayoyin cuta da kwayoyin halittar Mycobacterium masu jure wa magunguna ta hanyar amfani da multiplex PCR, kuma an sami haɗin amplicon na kwayoyin halittar da za a gano. Ana iya gina samfuran da aka ƙara zuwa ɗakunan karatu na tsara ta biyu ko ta ƙarni na uku masu tsayi, kuma duk dandamali na tsara ta biyu da ta ƙarni na uku za a iya yin su cikin zurfin jerin kwayoyin halitta don samun bayanai game da jerin kwayoyin halitta da aka yi niyya. Ta hanyar kwatanta da sauye-sauyen da aka sani da ke cikin bayanan da aka gina a cikin bayanan tunani (gami da kundin maye gurbin tarin fuka na WHO Mycobacterium da alaƙarsa da juriyar magunguna), an tantance sauye-sauyen da suka shafi juriyar magani ko kuma saurin kamuwa da magungunan hana tarin fuka. Tare da maganin maganin tarin fuka na Macro & Micro-Test da aka buɗe kai tsaye, an warware matsalar ƙarancin ingancin ƙara yawan ƙwayoyin cuta na samfuran fitsari na asibiti (sau goma fiye da na hanyoyin gargajiya), don haka ana iya amfani da gano juriyar magani kai tsaye ga samfuran maniyyi na asibiti.
Jerin gano samfur
34kwayoyin halitta masu alaƙa da juriyar magunguna18magungunan hana tarin fuka da kuma6An gano magungunan NTM, suna rufewa297Wuraren da ke jure wa magunguna; Nau'o'i goma na tarin fuka na Mycobacterium da fiye da haka190An gano nau'ikan NTM.
Tebur 1: Bayani game da Magunguna 18+6 +190+NTM
Amfanin samfur
Ƙarfin daidaitawar asibiti: ana iya gano samfuran maniyyi kai tsaye ta amfani da maganin shan ruwa na kai ba tare da al'ada ba.
Aikin gwaji abu ne mai sauƙi: zagaye na farko na aikin ƙara girma abu ne mai sauƙi, kuma ana kammala ginin ɗakin karatu cikin awanni 3, wanda ke inganta ingancin aiki.
Cikakken juriyar bugawa da kuma juriyar magani: rufe wuraren da MTB da NTM ke bi wajen buga rubutu da kuma juriyar magani, waɗanda su ne muhimman abubuwan da suka shafi asibiti, tantance daidaiton rubutu da kuma juriyar magani, tallafawa manhajar bincike mai zaman kanta, da kuma samar da rahotannin bincike da dannawa ɗaya.
Daidaituwa: dacewa da samfura, daidaitawa zuwa manyan dandamali na ILM da MGI/ONT.
Bayanin Samfuri
| Lambar samfur | sunan samfurin | Dandalin ganowa | ƙayyadaddun bayanai |
| HWTS-NGS-T001 | Kayan aikin gano nau'in Mycobacterium da kuma maganin juriya ga magunguna (hanyar faɗaɗawa da yawa) | ONT, Illumina, MGI, Salus pro | 16/96rxn |
Lokacin Saƙo: Janairu-23-2024