發(fā)布時間：2018-04-29 07:13

  本文選題：慢性阻塞性肺疾病 + 氣道炎癥��； 參考：《中國老年學(xué)雜志》2017年07期

【摘要】：目的探討穩(wěn)定期慢性阻塞性肺疾病(COPD)患者呼吸道潛在致病微生物(PPMs)的特點及其與氣道炎癥、COPD急性加重的關(guān)系。方法穩(wěn)定期COPD患者185例,采用自行咳痰或痰誘導(dǎo)方法留取合格痰液,進(jìn)行痰白細(xì)胞計數(shù)和細(xì)菌培養(yǎng)。隨后進(jìn)行隨訪,隨訪間歇3個月,共隨訪3次,每次隨訪均取痰液行痰白細(xì)胞計數(shù)和細(xì)菌培養(yǎng)。記錄隨訪期間COPD急性加重次數(shù)。結(jié)果總PPMs陽性率為37.3%,其中最常檢測到的PPMs為流感嗜血桿菌(HI)。與PPMs陰性組相比,PPMs陽性組的第1秒用力呼氣容積(FEV1)、FEV1/預(yù)計值、FEV1/用力肺活量(FVC)較低,而外周血中性粒細(xì)胞和百分比、痰白細(xì)胞、中性粒細(xì)胞和百分比較高(P0.05)。4個時點均完成痰液檢測的患者共有163例,PPMs陰性率、1次、2次、多次(3次或4次)PPMs陽性率分別為45.4%、23.3%、18.4%、12.9%,其中19例持續(xù)存在HI。與HI陰性組相比,HI陽性組痰白細(xì)胞、中性粒細(xì)胞和百分比均較高(P0.05)。結(jié)論穩(wěn)定期COPD患者呼吸道有較高的PPMs陽性率,尤其是流感嗜血桿菌持續(xù)存在于呼吸道中,并且與COPD氣道炎癥關(guān)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.
【作者單位】： 信陽職業(yè)技術(shù)學(xué)院護(hù)理學(xué)院;鄭州大學(xué)第三附屬醫(yī)院呼吸一病區(qū);
【分類號】：R563.9

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本文編號：1818943