急性加重期慢性阻塞性肺疾病合并持续喘息与痰真菌阳性的相关性分析  

Correlation analysis between the persistent wheezing of COPD and the positive result of sputum fungai culture

作　　者：刘放[1] 王冉[1] 毕爱萍[1] 冯学威[2] 

机构地区：[1]沈阳医学院奉天医院呼吸内科,110024 [2]中国医科大学附属盛京医院呼吸内科

出　　处：《中国实用医刊》2013年第5期7-9,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨急性加重期慢性阻塞性肺疾病（COPD）合并持续喘息与痰真菌培养阳性之间的相关性。方法收集2008年10月至2011年12月于沈阳医学院奉天医院呼吸科住院的急性加重期COPD患者的病例资料，进行回顾性分析。结果共收集到符合入选标准的COPD持续喘息组患者42例，COPD非喘息组患者40例。持续喘息组中38例（90．5％）痰真菌培养阳性，非喘息组中12例（30．0％）阳性，两组比较差异有统计学意义（P〈0．01）。而在真菌的菌种构成方面，持续喘息组痰真菌阳性患者中曲霉分离率为34．2％（13／38），非喘息组患者中未检出曲霉，曲霉在两组中分布差异有统计学意义（P〈0．05）。持续喘息组抗真菌治疗后症状缓解率显著高于未抗真菌治疗者（85．2％比45．5％，P〈0．05）。结论急性加重期COPD合并持续喘息与真菌，特别是曲霉在气道内定植感染有关。Objective To investigate the correlation between persistent wheezing and positive resuk of sputum fungal culture in patients with chronic obstructive pulmonary disease（COPD）. Methods The COPD patients who hospitalized in the respiratory department from October 2008 to December 2011 were analyzed retrospectively. Results Forty-two cases were enrolled in the persistent wheezing group and 40 cases in the non-wheezing group. In the wheezing group, sputum fungal culture revealed positive yield in 38 cases （90.5%）while Aspergillus were isolated in 13 cases（34. 2% ）. In the non-wheezing group, sputum fungal culture revealed only 12 cases（30.0% ） positive, and none of which were Aspergillus positive. Aspergillus distributions in the two groups were significantly different （P 〈 0. 05 ）. There was also significant difference in the positive result of sputum fungal culture （P 〈 0. 01 ）. In the wheezing group, the patients with antifungal treatment showed better prognosis than those without antifungal treatment（85.2% vs 45.5% , P 〈 0. 05 ）. Conclusions The persistent wheezing in the patients with COPD is correlated with the fungi, especially Aspergillus airway colonization.

关 键 词：慢性阻塞性肺疾病 持续喘息 感染 真菌 

分 类 号：R563.9[医药卫生—呼吸系统]