摘要
目的探讨慢性阻塞性肺疾病急性加重期(AECOPD)患者的病原学特点及其与肺功能的关系。方法对64例AECOPD患者行肺功能测定,痰细菌定量和定性培养和药物敏感试验,以及血清支原体、衣原体抗体检测。根据肺功能第1秒用力呼气容积占预计值百分比(FEV1%pred),将患者分为三组:Ⅰ组(50%≤FEV1<80%pred)、Ⅱ组(30%≤FEV1<50%pred)和Ⅲ组(FEV1<30%pred);同时根据痰培养结果将感染细菌分为A(G+菌),B(除C类以外的G-菌),C(不动杆菌、肠杆菌及假单胞菌),D(痰菌阴性)四类。比较三组患者肺功能损伤程度与感染细菌种类之间的关系。结果(1)64例行痰定量培养患者感染细菌以肺炎链球菌、肠杆菌、卡他莫拉菌及假单胞菌为主。其中38例同时行痰定性培养的住院患者以肺炎链球菌、表皮葡萄球菌、不动杆菌和肠杆菌为主,且多为混合感染。(2)痰定量与定性培养均为Ⅰ组患者以痰菌阴性为主,Ⅲ组患者以耐药A类菌及C类菌为主(分别为P<0.01,P<0.05)。(3)29.4%的AECOPD患者有支原体或衣原体感染。结论AECOPD患者感染细菌种类与肺功能损害的严重程度密切相关,肺功能损害越严重,耐药肺炎链球菌等G+球菌、不动杆菌、肠杆菌及假单胞菌分离率越高。
Objective To investigate the pathogenic characteristics and the possible relationship between pathogen and respiratory function in patients with acute exacerbations of chronic obstructive pulmonary disease （AECOPD）. Methods Sixty-four patients with AECOPD were investigated with lung function test, quantitative and qualitative sputum bacteria culture, drug sensitive test, and Mycoplasma pneumoniae and Chlamydia pneumoniae specific antibodies test. The patients were divided into three groups according to FEV1 % pred,ie.50% ≤FEV1 〈 80% pred for the Group One, 30% pred ≤ FEV1 〈 50% pred for the Group Two, and FEV1 〈 30% pred for the Group Three. Meanwhile according to the result of sputum culture, infective bacteria were divided into four kinds： Gram-positive cocci for kind A, Gram-negtive germ except kind C for kind B, Acinewbacter, Enterobacter and Pseudomonas spp. for kind C, and negative result for kind D. Results Of 64 patients who were conducted quantitative sputum culture, germs isolated were mostly Streptococcus pneumoniae, Enterobacter , Moraxella Catarrhalis , and Pseudomonas spp . Of 38 patients who were conducted qualitative sputum culture,most of them were found mixed infection, and germs isolated were mostly Streptococcus pneumoniae, Staphylococcus epidermidis, Acinetobacter and Enterobacter. Both quantitative and qualitative sputum culture revealed that most of Group One patients were not infected by bacteria, and the Group Three patients were mainly by resistant kind A and kind C bacteria （ P 〈 0.01 and 0.05 respectively）. The infection of Mycoplasma pneumoniae or Chlamydia pneumoniae was identified in 29.4% of the cases. Conclusions There is a close correlation between the degree of functional damage and the infected bacterial strains for patients with AECOPD, the more chance of bacteria infection such as S. pneumoniae , Acinetobacter , Enterobacter and Pseudomonas spp , the more damage of lung function.
出处
《中国呼吸与危重监护杂志》
CAS
2007年第2期88-92,共5页
Chinese Journal of Respiratory and Critical Care Medicine
基金
山西省卫生厅科技攻关项目(编号:200506)
关键词
慢性阻塞性肺疾病
病原学
肺功能
Chronic obstructive pulmonary disease
Pathogen
Lung function
作者简介
通讯作者：许建英，E-mail：xujyty@tom．com
