慢性鼻窦炎对COPD影响相关分析  

Effect of chronic sinusitis on chronic obstructive pulmonary disease

作　　者：曾美娥[1] 叶水芬[1] 邓小援[1] 

机构地区：[1]福建医科大学附属龙岩第一医院,龙岩364000

出　　处：《新医学》2016年第11期747-751,共5页Journal of New Medicine

摘　　要：目的探讨慢性鼻窦炎对COPD患者的影响。方法收集符合入选标准的125例COPD患者,根据鼻窦CT检查有无鼻窦炎分为单纯COPD组和COPD合并慢性鼻窦炎组,对患者病史、2年内急性加重次数、住院时间及痰培养结果进行分析。结果 2组患者的年龄、性别、咳喘史、吸烟史情况比较差异均无统计学意义(P均>0.05)。跟据鼻窦CT结果,125例COPD患者中有67例患者合并慢性鼻窦炎(54%)。COPD合并慢性鼻窦炎患者鼻窦受累以上颌窦和筛窦为主,多数患者多个鼻窦合并受累,其中具有鼻部症状表现者占67.2%,以鼻塞、流涕为主要表现。COPD合并慢性鼻窦炎组患者过去2年内重度急性加重的次数、痰培养阳性检出率、住院天数均高于单纯COPD组(P均<0.05)。单纯COPD组患者细菌检出以肺炎克雷伯菌、铜绿假单胞菌为代表的革兰阴性菌为主,而COPD合并慢性鼻窦炎组患者细菌检出种类较单纯COPD组多且阳性球菌及白假丝酵母菌检出率高,但差异均无统计学意义(P均>0.05)。结论 COPD合并慢性鼻窦炎临床常见,慢性鼻窦炎增加COPD患者急性加重次数及住院时间,COPD合并慢性鼻窦炎患者痰培养阳性检出率高。Objective To investigate the effect of chronic sinusitis upon patients with chronic obstructive pulmonary disease （COPD）. Methods In total, 125 COPD patients who met the inclusion criteria were recruited in this study. According to the results of CT scan of nasal sinus, all patients were divided into simple COPD group and COPD complicated with chronic sinusitis group. The patients ’ medical history, the frequency of acute exacerbation in recent two years, the length of hospital stay and the results of sputum culture were analyzed. Results There was no statistical significance in age, gender, the medical history of cough and asthma and smoking history between two groups （all P 〉0. 05）. CT scan of nasal sinus revealed that 54% of COPD patients were complicated with chronic sinusitis. The maxillary sinus and ethmoid sinus were the most commonly involved sites. Multiple sinuses were affected in a majority of patients. In total, 67. 2% of COPD patients complicated with chronic sinusitis presented with nasal symptoms, dominantly nasal congestion and runny nose. In COPD complicated with chronic sinusitis group, the frequency of acute exacerbation in recent two years, positive rate of sputum culture, and the length of hospital stay were significantly higher compared with those in simple COPD group （all P 〈0. 05）. Gramnegative bacteria,such as Klebsiella pneumoniae and Pseudomonas aeruginosa were the dominant bacteria detected in COPD patients. In COPD complicated with chronic sinusitis group, the type of bacteria was increased and the detection rate of Gram-positive bacteria and Candida albicans was slightly higher compared with those in simple COPD group with no statistical significance （all P 〉 0. 05 ） . Conclusions COPD patients are constantly complicated with chronic sinusitis in the clinical settings. Chronic sinusitis increases the frequency of acute exacerbation, length of hospital stay, positive rate of sputum culture.

关 键 词：慢性阻塞性肺疾病 鼻窦炎 细菌学 

分 类 号：R765.41[医药卫生—耳鼻咽喉科]