慢性阻塞性肺疾病和支气管哮喘患者社区获得性肺炎时病原学检测情况及分析  

Etiological detection and analysis of community acquired pneumonia in patients with chronic obstructive pulmonary disease and bronchial asthma

作　　者：余小丽[1] 陈愉生[1] 林明[1] 岳文香[1] 林晓红[1] 胡辛兰[1] YU Xiao-li;CHEN Yu-sheng;LIN Ming;YUE Wen-xiang;LIN Xiao-hong;HU Xin-lan(Department of Respiratory and Critical Care Medicine,Fujian Provincial Hospital,Fujian Provincial Medical College of Fujian Medical University,Fuzhou,Fujian350001,China)

机构地区：[1]福建省立医院呼吸与危重症医学科,福建福州350001

出　　处：《临床肺科杂志》2020年第12期1822-1826,共5页Journal of Clinical Pulmonary Medicine

基　　金：国家重大科技专项(No.2017ZX10103004);福建省卫生计生青年科研课题(2018-1-2)。

摘　　要：目的探讨慢性阻塞性肺疾病(COPD)和支气管哮喘患者患有社区获得性肺炎时,细菌和病毒感染情况。方法应用微生物培养法、液态芯片法、实时荧光定量PCR法(RT-PCR)检测我院呼吸内科COPD和或支气管哮喘患者社区获得性肺炎时的痰或肺泡灌洗液体标本中的细菌和病毒,并对结果进行统计分析。结果113例标本中,液态芯片法和微生物培养法分别检出细菌54株(47.7%)和9株(7.9%),两种方法相比检出率具有统计学差异(P<0.05)。液态芯片法和RT-PCR法分别检出病毒51株(45.1%)和53株(46.9%),以巨细胞病毒和甲型流感病毒为主,两者相比差异无统计学意义(P>0.05)。113例中同时检出细菌和病毒18例(15.9%)。COPD和支气管哮喘相比,两者在革兰阴性菌、革兰阳性菌和病毒检出率对比,差异无统计学意义(P>0.05)。时间分布上,甲型流感病毒检出病例多发生在3月和7月,巨细胞病毒全年散在分布。结论COPD和或支气管哮喘患社区获得性肺炎时,细菌和病毒均具有较高检出率,液态芯片法检测对病原学分析可提供重要临床线索。Objective To investigate bacterial and viral infections in community acquired pneumonia patients who also diagnosed with chronic obstructive pulmonary disease(COPD)or bronchial asthma.Methods Microbial culture method,liquid chip technology and real-time fluorescence quantitative PCR(RT-PCR)were used to detect bacterium and virus in sputum or alveolar lavage fluid specimens in community acquired pneumonia hospitalized patients who also diagnosed with COPD or bronchial asthma,and the results were analyzed.Results Among the 113 specimens,54(47.7%)and 9(7.9%)stains of bacteria were respectively detected by liquid chip technology and microbial culture method(P<0.05).The liquid chip technology and RT-PCR method detected 51(45.1%)and 53(46.9%)strains of viruses respectively,mainly in the cytomegalovirus and influenza A virus(P>0.05).In the 113 specimens,18 specimens(15.9%)were detected bacteria and viruses at the same time.Between COPD and bronchial asthma,there was no significant difference in the detection rate of gram-negative bacteria,gram-positive bacteria and viruses(P>0.05).In terms of time distribution,most cases of influenza A virus infection occurred in March and July,while cytomegalovirus infection scattered throughout the year.Conclusion Both COPD and bronchial asthma during the time of community acquired pneumonia have high detection rate of bacteria and viruses.Liquid chip technology can provide important clinical clues for etiological analysis.

关 键 词：COPD 支气管哮喘 社区获得性肺炎 液态芯片法 实时荧光定量PCR 

分 类 号：R563.9[医药卫生—呼吸系统] R562.25[医药卫生—内科学]