摘要
【目的】探讨下呼吸道细菌定植（lower airway bacterial colonization，LABC）对老年慢性阻塞性肺疾病（COPD）稳定期患者预后与转归的影响。【方法】选择2016年5月至2017年8月本院诊治的老年稳定期COPD患者85例，对其痰液进行细茵学培养。根据是否发生LABC分为定植组（53例）和非定植组（32例），比较两组患者血清炎性因子水平、发作情况、肺功能分级等指标。【结果】85例老年COPD稳定期患者发生LABC53例，发生率为62．35％；定植细菌主要是流感嗜血杆菌（30．19％）、肺炎链球茵（16．98％）、卡他莫拉茵（13．21％）等，定植茵株百分比与定植量基本呈正相关；定植组血清白细胞介素-8（IL-8）、超敏C反应蛋白（hs-CRP）水平、每年平均急性发作次数、合并下呼吸道感染均高于非定植组（t／X^2为9．615，7．487，5．817，13．833，均P〈0．05），肺功能分级极重度率为18．87％，明显高于非定植组3．13％（X^2=4．389，P〈0．05）。【结论】老年cOPD稳定期患者下呼吸道细菌定植发生率高，细茵定植可加重气道炎性反应，增加急性发作及下呼吸道感染率，降低肺功能，严重影响患者的预后与转归。
[Objective]To investigate the effect of low airway bacterial colonization （LABC） on the outcomes and prognosis of senile patients with chronic obstructive pulmonary disease （COPD） at stable stage, and to provide reference for assessing the severity of disease and treatment. [Methods]A total of 85 elderly patients with stable COPD from May 2016 to August 2017 were selected as the study subjects and quantitative bacterial cultures were performed on their in- duced sputum. According to whether or not LABC occurred, they were divided into colonization group （53 cases） and non-colonization group （32 cases）. The levels of serum inflammatory factors, symptoms, and lung function grading were compared between the two groups. [Results]A total of 83 elderly patients with stable COPD contained 53 cases of LABC; the incidence rate was 62.35%. The main bacteria were haemophilus influenzae （30.19%）, Streptococcus pneumoniae （16.98 % ） and Moraxella catarrhalis （13.21% ）. The proportion of colonizing strains and the amount of colonization were positively correlated. The levels of serum interleukin-8 （IL-8）, high-sensitivity C-reactive protein （hs-CRP）, the average number of acute exacerbations per year, and the rate of combined lower respiratory tract infection were higher in the colo- nization group than in the non-colonization group （ t/Xz =9.615, 7.487, 5.817, 13.833, P 〈 0.05, P〈0.01）. The ex- tremely severe rate of lung function classification was 18.87 %, significantly higher than that of the non-colonization group （3.13%） （X^2 =4.389, P %0.05）. [Conclusion]The incidence of low airway bacterial colonization of elderly patients with COPD at the stable stage is high. Bacterial colonization can aggravate the airway inflammatory reaction, increase the inci- dence of acute attacks and lower respiratory infection, reduce lung function, and seriously affect the outeomes and progno- sis of patients.
作者
李有军
毛建川
LI You-jun;MAO Jian-chuan(Department of Respiratory Medicine, Yuechi People＇s Hospital, Yuechi, Sichuan 638300, Chin)
出处
《医学临床研究》
CAS
2018年第6期1076-1078,1082,共4页
Journal of Clinical Research
