稳定期慢性阻塞性肺疾病患者呼吸道潜在致病微生物特点及对气道炎症的影响

发布时间：2018-04-29 07:13

本文选题：慢性阻塞性肺疾病 + 气道炎症　；参考：《中国老年学杂志》2017年07期

【摘要】：目的探讨稳定期慢性阻塞性肺疾病(COPD)患者呼吸道潜在致病微生物(PPMs)的特点及其与气道炎症、COPD急性加重的关系。方法稳定期COPD患者185例,采用自行咳痰或痰诱导方法留取合格痰液,进行痰白细胞计数和细菌培养。随后进行随访,随访间歇3个月,共随访3次,每次随访均取痰液行痰白细胞计数和细菌培养。记录随访期间COPD急性加重次数。结果总PPMs阳性率为37.3%,其中最常检测到的PPMs为流感嗜血杆菌(HI)。与PPMs阴性组相比,PPMs阳性组的第1秒用力呼气容积(FEV1)、FEV1/预计值、FEV1/用力肺活量(FVC)较低,而外周血中性粒细胞和百分比、痰白细胞、中性粒细胞和百分比较高(P0.05)。4个时点均完成痰液检测的患者共有163例,PPMs阴性率、1次、2次、多次(3次或4次)PPMs阳性率分别为45.4%、23.3%、18.4%、12.9%,其中19例持续存在HI。与HI阴性组相比,HI阳性组痰白细胞、中性粒细胞和百分比均较高(P0.05)。结论稳定期COPD患者呼吸道有较高的PPMs阳性率,尤其是流感嗜血杆菌持续存在于呼吸道中,并且与COPD气道炎症关系密切。
[Abstract]:Objective to investigate the characteristics of PPMs in respiratory tract of patients with stable chronic obstructive pulmonary disease (COPD) and the relationship between PPMs and acute exacerbation of COPD. Methods 185 patients with stable COPD were treated with sputum or sputum induction for sputum white blood cell count and bacterial culture. The sputum was followed up for 3 months, and sputum white blood cell count and bacterial culture were collected for each follow-up. The number of acute exacerbations of COPD during follow-up was recorded. Results the total positive rate of PPMs was 37.3%, and the most commonly detected PPMs was Haemophilus influenzae. Compared with PPMs negative group, the forced expiratory volume of FEV1 / predicted FEV1 / FEV1 / FEV1 / FEV1 / FEV1 / FEV1 / FVC1 / FEV1 / FEV1 / FEV1 / FVC1 / FEV1 / FV1 / FEV1 / FVC1 / FEV1 / FV1 / FEV1 / FEV1 / There were 163 patients who had completed sputum examination at four time points. The negative rate of PPMs was twice, and the positive rates of PPMs for three or four times were 45.4% and 23.43%, respectively. Among them, 19 cases had persistent infection of HII. the positive rate of PPMs in the sputum was significantly higher than that in the control group (P < 0.05), and the positive rate of PPMs was 45.4% (P < 0.05), respectively. Compared with HI negative group, the sputum leukocytes, neutrophils and percentage of neutrophils in the positive group were higher than that in the HI negative group (P 0.05). Conclusion there is a high positive rate of PPMs in respiratory tract of patients with stable COPD, especially Haemophilus influenzae is persistent in respiratory tract and is closely related to airway inflammation of COPD.
【作者单位】：信阳职业技术学院护理学院;郑州大学第三附属医院呼吸一病区;
【分类号】：R563.9

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