病毒感染对慢性阻塞性肺疾病患者气道炎症的作用  

Effect of Virus Infections on the Airway Inflammation in Patients with Chronic Obstructive Pulmonary Disease (COPD)

作　　者：徐少华[1] 王伟[1] 柏玉红[2] 柳相珍[1] 邵红艳[1] 赵业芳[1] 

机构地区：[1]山东大学第二医院,山东济南250033 [2]威海市立医院,山东威海264200

出　　处：《中华医院感染学杂志》2004年第11期1209-1211,共3页Chinese Journal of Nosocomiology

摘　　要：目的　探讨病毒感染与慢性阻塞性肺疾病 ( COPD)的关系及其对气道炎症的作用。方法　收集 COPD急性加重期患者 84例及 2 3例健康人血清 ,应用 EL ISA方法检测患者呼吸道合胞病毒 ( RSV)、单纯疱疹病毒 型( HSV- 1)、副流感病毒 ( PIV)、巨细胞病毒 ( CMV)、腺病毒 ( ADV)的特异性 Ig M、Ig G抗体 ;根据病毒检测结果及临床表现分成 2组 :病毒感染组 ( A组 )及细菌感染组 ( B组 ) ;用 EL ISA法检测 A、B两组患者治疗前后诱导痰液中白介素 8( IL- 8)和肿瘤坏死因子 α( TNF- α)的水平。结果　 84例 COPD急性加重患者 81例检测到病毒抗体 ,Ig M阳性者 2 8例 ( 33.3% ) ,其中 RSVIg M比例最高 ( 5 3.5 % ) ,其次为 PIV( 2 6 .7% ) ;Ig M阳性与感冒样症状、无脓痰等有关 ;经治疗后 A、B两组痰液 IL- 8和 TNF- α水平显著降低 ( P<0 .0 5 ) ,A组治疗后 IL- 8下降更明显( P<0 .0 5 ) ,TNF- α水平的变化两组间差异无显著性。结论　病毒感染是 COPD急性加重的重要因素 。OBJECTIVE To study the relationship between virus infection and COPD, and to explore the effect of virus infections on the airway inflammation in patients with COPD. METHODS Serum samples from 84 patients with acute exacerbation of COPD and 23 healthy subjects were tested for specific IgM and IgG of respiratory syncytial virus (RSV), herpes simplex virus type 1 (HSV-1), parainfluenza virus (PIV), adenovirus (ADV) and cytomegalovirus (CMV) with indirect enzyme-linked immunosorbent assay (ELISA). According to the virus-IgM and clinical representation, 60 patients were divided into 2 groups: group A (virus infection) and group B (bacterial infection). The interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-α) in induced sputum before and after therapy were determined by ELISA. RESULTS Eighty one COPD patients had the positive virus results and 28 (33.3%) cases had IgM positive. RSV IgM and PIV IgM were detected in 15 (53.5%) and 8 (26.7%) patients in group A. Respiratory virus infection was associated with cold symptom and no pus sputum. The levels of IL-8 and TNF-α in sputum in exacerbation were significantly higher than that after therapy (all P<0.05). Compared with group B, sputum IL-8 decreased more significantly in group A (P<0.05) while there were no difference of sputum TNF-α changes between two groups. CONCLUSIONS Viral infection is common and important in acute exacerbation of COPD, and it may aggravate the airway inflammation.

关 键 词：肺疾病 阻塞性 病毒 气道 炎症 

分 类 号：R562.2[医药卫生—呼吸系统]