慢性阻塞性肺疾病急性加重患者相关病毒感染的危险因素分析

发布时间：2019-02-26 21:36

【摘要】：目的探讨慢性阻塞性肺疾病急性加重(AECOPD)患者病毒感染的相关因素,为进一步改善COPD患者病情,提供针对性治疗方案。方法选取2014年5月-2015年5月医院就诊AECOPD患者175例,采用鼻拭子获取分泌物及鼻黏膜细胞,使用15联呼吸道病毒荧光标记PCR检测试剂盒进行检测,并使用临床登记观察表记录患者临床相关信息,分析AECOPD患者病毒感染的相关因素,使用频数分析、logistic回归进行统计分析。结果 175例AECOPD患者病毒检测阳性68例,阳性率为38.86%;检出病毒70株,其中排前5位的病毒为呼吸道合胞病毒B型(16株,22.86%),鼻病毒A/B/C(10株,14.29%)、偏肺病毒(9株,12.86%)、人博卡病毒1/2/3/4(7株,10.00%)、冠状病毒OC43(7株,10.00%);病毒检测阳性与阴性患者相比,体质量指数差异有统计学意义(P0.05);logistic单因素分析及多因素分析结果显示,糖尿病、吸烟、呼吸衰竭、上1年加重次数、体质量指数下降是COPD急性加重期患者病毒感染的重要危险因素(P0.05)。结论病毒感染是导致AECOPD患者的常见原因之一,糖尿病、吸烟、呼吸衰竭、体质量指数下降、上1年急性加重次数增多是呼吸道病毒感染的危险因素,控制体重、吸烟、降低血糖等对预防AECOPD患者病毒感染具有一定的临床意义。
[Abstract]:Objective to explore the factors related to the acute exacerbation of (AECOPD) in patients with chronic obstructive pulmonary disease (COPD) and to provide a targeted treatment scheme for the further improvement of the condition of COPD patients. Methods from May 2014 to May 2015, a total of 175 patients with AECOPD were selected. Secretions and nasal mucosal cells were obtained from nasal swabs. 15 respiratory tract virus fluorescent labeled PCR kits were used for detection. The clinical information of the patients was recorded by clinical registration observation table, and the related factors of viral infection in AECOPD patients were analyzed. The frequency analysis and logistic regression were used for statistical analysis. Results the positive rate of virus detection was 38.86% (68 / 175) in AECOPD patients. 70 strains were detected, among which the top 5 strains were respiratory syncytial virus B (16 strains, 22.86%), rhinovirus A/B/C (10 strains, 14.29%), metapneumovirus (9 strains, 12.86%), and respiratory syncytial virus B (16 strains, 22.86%), rhinovirus (10 strains, 14.29%). Human Boca virus 1, 2, 3, 4 (7 strains, 10.00%) and coronavirus OC43 (7 strains, 10.00%); There was a significant difference in body mass index between positive and negative patients (P0.05). The results of logistic univariate analysis and multivariate analysis showed that diabetes, smoking, respiratory failure, the number of exacerbations in the previous year and the decrease of body mass index were the important risk factors of viral infection in patients with acute exacerbation of COPD (P0.05). Conclusion viral infection is one of the common causes of AECOPD. Diabetes, smoking, respiratory failure, decreased body mass index (BMI) and the increase of acute exacerbation in the last year are the risk factors of respiratory tract virus infection, weight control, smoking, and so on. Reducing blood sugar has certain clinical significance in preventing virus infection in patients with AECOPD.
【作者单位】：瑞安市人民医院呼吸科;
【基金】：浙江省医药卫生一般研究计划基金资助项目(2013KYA223)52~1165
【分类号】：R563.9

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