慢性阻塞性肺疾病稳定期下呼吸道细菌定植与疾病分级、评估的相关性  

Correlation study between bacterial colonization in lower respiratory tract and disease classification and evaluation during chronic obstructive pulmonary disease stabilization

作　　者：刘雁冰[1] 李陶 肖林[1] 胡东曙 周粉乐 靳晓宇 刘丹[1] 戢杨[1] Liu Yanbing;Li Tao;Xiao Lin;Hu Dongshu;Zhou Fenle;Jin Xiaoyu;Liu Dan;Ji Yang(Department of Respiratory,the 272th Hospital of PLA,TianJin 300000,China)

机构地区：[1]中国人民解放军第272医院呼吸科,天津300000

出　　处：《中华肺部疾病杂志（电子版）》2018年第6期708-712,共5页Chinese Journal of Lung Diseases(Electronic Edition)

摘　　要：目的探讨慢性阻塞性肺病(COPD)患者稳定期下呼吸道细菌定植状况与肺功能分级、症状评估和急性加重频率的关系。方法入选中、重度COPD稳定期患者60例,痰液标本行细菌半定量培养,并行血常规、血气分析、肺功能检测及CAT、SGRQ生活质量问卷调查。结果 60例患者中,痰细菌半定量培养≥+++者为30%(18/60),主要定植细菌为副流感嗜血杆菌、铜绿假单胞菌、肺炎链球菌、肺炎克雷伯菌、流感嗜血杆菌;肺功能分级:1级0例,2级24例(40%),3级24例(40%),4级12例(20%);症状和急性加重频率分组:A组6例,B组18例,C组0例,D组36例;存在细菌定植的患者与无细菌定植者在每年急性发作次数、肺功能、SGRQ评分和CAT评分差别有统计学意义(P<0.05);稳定期细菌定植与急性加重次数、肺功能分级、CAT评分、SGRQ得分总分、症状得分、日常生活影响得分呈正相关(P<0.01、P<0.05);与FEV1%预计值、FEV1/FVC存在负相关(P<0.01); CAT评分与SGRQ的各项评分均有显著的相关性。结论 COPD稳定期患者中,部分患者存在下呼吸道细菌定植,细菌定植者比无细菌定植者表现出更差的肺功能和生活质量,且更易出现急性加重,CAT评分能较客观地反映患者的临床症状,而且简便易行操作性更强。Objective To investigate the relationship between bacterial colonization in lower respiratory tract and pulmonary function classification,symptom assessment and acute exacerbation frequency in patients with chronic obstructive pulmonary disease(COPD)at stable stage.Methods A total of 60 patients with stable COPD were enrolled in this study.Sputum samples were collected for semi quantitative culture of bacteria,blood routine examination,blood gas analysis,lung function,CAT and SGRQ quality of life questionnaire.Results In 60 cases,semi quantitative sputum bacteria culture=+++was 30%(18/60),mainly for bacterial colonization of Haemophilus parainfluenzae,Pseudomonas aeruginosa,Streptococcus pneumoniae,Klebsiella pneumoniae,Haemophilus influenzae;lung function grading:Grade 1 in 0 cases,24 cases of grade 2(40%),grade 3 in 24 cases(40%),4(20%);12 cases of symptoms and acute exacerbation frequency group:6 cases in A group,B group of 18 cases,0 cases of C group,D group of up to 36 cases;the presence of bacterial colonization in patients with non bacterial colonization in the annual number of acute attack,pulmonary function,SGRQ score and CAT score difference was statistically significant(P<0.05);stable bacterial colonization and the frequency of acute exacerbation,lung function,CAT score,SGRQ score,total symptom score,daily life impact scores were positively correlated(P<0.01,P<0.05);there is a negative correlation,and FEV1/FVC FEV1%is expected to(P<0.01);the CAT score was significantly correlated with the scores of SGRQ.Conclusion Patients with stable COPD,part of patients with lower respiratory tract bacterial colonization and bacterial colonization than non bacterial colonization showed worse lung function and quality of life,and more prone to acute exacerbation,CAT score can objectively reflect the clinical symptoms of the patients,and simple operation more.

关 键 词：肺疾病稳定期慢性阻塞性 下呼吸道细菌定植 肺功能 疾病评估 急性加重 

分 类 号：R563[医药卫生—呼吸系统]