慢性阻塞性肺疾病患者发生肺部感染的相关因素及血清炎症因子分析  

Analysis on risk factors of pulmonary infection in the patients with chronic obstructive pulmonary disease and serum inflammatory factors

作　　者：古辉[1] 彭昌[1] 谭俊锋[1] 夏婉飞 GU Hui;PENG Chang;TAN Jun-feng;XIA Wan-fei(Gaoming People's Hospital,Foshan 528500,China)

机构地区：[1]广东省佛山市高明区人民医院呼吸内科,广东佛山528500

出　　处：《广东医科大学学报》2018年第5期497-500,共4页Journal of Guangdong Medical University

摘　　要：目的探讨导致慢性阻塞性肺疾病(COPD)患者发生肺部感染的危险因素,并分析感染后血清炎症因子变化。方法选取COPD患者例,按是否发生肺部感染分为感染组和非感染组,对相关因素先单独应用t92检验和卡方检验进行单因素分析,对有统计学意义的因素再进行Logistic回归分析;比较感染组和非感染组炎症因子的差异。结果Logistics回归分析结果显示,应用抗生素时间、机械通气、糖尿病史以及应用糖皮质激素为导致肺部感染的独立因素;相对于非感染组,感染组血清白细胞介素(IL-1β、IL-2、IL-4、IL-6、IL-8、IL-10)、肿瘤坏死因子(TNF-α、TNF-β)以及干扰素(IFN-α、IFN-γ)水平均有不同程度升高(P<0.01或0.05),IL-2与IL-8的升高尤为显著。结论长时间应用抗生素、机械通气以及应用糖皮质激素均易导致COPD患者发生肺部感染,因此临床上对于该类患者应尽量减少上述操作。由于患有糖尿病的患者易发生肺部感染,临床医生应格外重视,并采取相应措施预防肺部感染发生。临床上检测相关炎症因子(尤其是IL-2与IL-8),对于肺部感染的诊断与治疗有一定的指导意义。Objective To investigate risk factors of pulmonary infection in the patients with chronic obstructive pulmonary disease(COPD)and to analyze the changes in serum inflammatory factors after infection.Methods A total of 92 patients with COPD were selected and divided into Infection Group and Non-Infection Group according to whether there was infection.Single factor analysis was conducted on relevant factors with t-test and chi-square test,and logistic regression analysis was conducted on the factors with statistical significance.The difference in inflammatory factors between the Infection Group and Non-Infection Group was compared.Results The results of logistic regression analysis showed that the duration of the application of antibiotics,mechanical ventilation,diabetes history and application of glucocorticoids were independent factors leading to lung infection.Compared with the Non-Infection Group,the Infection Group had an increase in the serum interleukin(IL-1β,IL-2 IL-4,IL-6,IL-8 and IL-10),tumor necrosis factor(TNF-α,TNF-β)and interferon(IFN-α,IFN-γ)levels with varying degrees(P<0.01 or 0.05),and the increase in the IL-2 and IL-8 was more significant.Conclusion Long-term application of antibiotics,mechanical ventilation and the application of glucocorticoids can easily lead to pulmonary infection in patients with COPD.Therefore,such clinical operations should be minimized for patients with COPD.Because patients with diabetes are prone to pulmonary infection,special attention should be paid and appropriate measures should be taken to prevent it.The clinical detection of related inflammatory factors(especially IL-2 and IL-8)has certain guiding significance for the diagnosis and treatment of pulmonary infection.

关 键 词：慢性阻塞性肺疾病 感染 炎症因子 相关因素 

分 类 号：R563[医药卫生—呼吸系统]