支气管扩张/肺癌合并慢性阻塞性肺病患者肺泡灌洗液微生物群及肺功能比较分析  

Comparison of bronchoalveolar lavage fluid microbiota and pulmonary function in patients with bronchiectasis/lung cancer complicated by COPD

作　　者：李蔚[1] 安兴 伍灿 LI Wei;AN Xing;WU Can(Department of Respiratory and Critical Care Medicine,Chongqing Traditio Chinese Medicine Hospital,Chongqing,400020,China)

机构地区：[1]重庆市中医院呼吸与危重症医学科,重庆400020

出　　处：《中国病原生物学杂志》2025年第5期563-568,共6页Journal of Pathogen Biology

基　　金：2021年重庆市科研机构绩效激励引导专项项目(No.jxyn2021-1-15)。

摘　　要：目的本研究评估了支气管扩张、肺癌及其与COPD合并患者的肺功能和肺泡灌洗液(BALF)微生物群特征,旨在探讨COPD合并对肺功能的影响及肺部微生物群的分布特征。方法研究纳入了支气管扩张(BE组,35名患者)、肺癌(LC组,32名患者)、支气管扩张合并COPD(BE-COPD组,27名患者)、肺癌合并COPD(LC-COPD组,29名患者)和支气管扩张与肺癌合并COPD(BE-LC-COPD组,18名患者)五组患者,年龄40~75岁。系统评估了用力呼气量(FEV1)、用力肺活量(FVC)、FEV1/FVC比值、肺总量(TLC)、功能残气量(FRC)和一氧化碳弥散量(DLCO)。通过微生物群落分析,比较了BALF中微生物相对丰度,并计算香农指数和辛普森指数评估微生物多样性。同时,识别了BALF中前30个细菌属,并探讨了它们之间的共存和共斥关系。结果肺功能测试结果显示,肺功能测试结果表明BE组的FEV1(2.31±0.26 L)显著高于BE-COPD组(1.58±0.22 L,P<0.01)、BE-LC-COPD组(0.97±0.16 L,P<0.01)。BE组的FVC(3.21±0.42 L)也显著高于BE-COPD组(2.01±0.26 L,P<0.01)、BE-LC-COPD组(1.23±0.20 L,P<0.01)。BE组的FEV1/FVC比值(76.4%±3.68%)显著高于BE-COPD组(62.3%±2.64%,P<0.01)、BE-LC-COPD组(45.6%±2.47%,P<0.01)。TLC、FRC和DLCO的结果也显示了类似的显著差异。微生物群落分析表明BE组以Staphylococcus和Veillonella为主,而LC组以Haemophilus和Klebsiella为主。合并COPD的组别显示出更低的微生物群落多样性,香农指数和辛普森指数的结果均表明BE-COPD组、LC-COPD组和BE-LC-COPD组的微生物群落多样性较低(P<0.01)。另外BE组中Pasteurella和Bacillus之间存在显著的共存关系,而Bosea和Brevundimonas之间显示出共斥关系。LC组中Staphylococcus和Acinetobacter的共存关系可能与肺癌患者肺部微环境的特定变化有关。结论本研究结果强调了COPD合并对肺功能的影响以及不同疾病状态下肺部微生物群落结构的变化,为进一步研究肺部微生物群与呼吸疾病之间的关Objective This study assessed pulmonary function and bronchoalveolar lavage fluid(BALF)microbiota characteristics in patients with bronchiectasis,lung cancer,and their co-occurrence with COPD,aiming to explore the impact of COPD co-occurrence on pulmonary function and the distribution characteristics of pulmonary microbiota.Methods The study included five groups of patients:bronchiectasis(BE group,35 patients),lung cancer(LC group,32 patients),bronchiectasis with COPD(BE-COPD group,27 patients),lung cancer with COPD(LC-COPD group,29 patients),and bronchiectasis and lung cancer with COPD(BE-LC-COPD group,18 patients),aged 40 to 75.Forced expiratory volume in one second(FEV1),forced vital capacity(FVC),FEV1/FVC ratio,total lung capacity(TLC),functional residual capacity(FRC),and diffusing capacity of carbon monoxide(DLCO)were systematically evaluated.Microbiota community analysis compared the relative abundance of microbes in BALF and calculated the Shannon and Simpson indices to assess microbial diversity.Additionally,the top 30 bacterial genera in BALF were identified,and their coexistence and exclusion relationships were explored.Results Pulmonary function test results indicated that the FEV1 in the BE group(2.31±0.26 L)was significantly higher than in the BE-COPD group(1.58±0.22 L,P<0.01)and the BE-LC-COPD group(0.97±0.16 L,P<0.01).The FVC in the BE group(3.21±0.42 L)was also significantly higher than in the BE-COPD group(2.01±0.26 L,P<0.01)and the BE-LC-COPD group(1.23±0.20 L,P<0.01).The FEV1/FVC ratio in the BE group(76.4%3.68%)was significantly higher than in the BE-COPD group(62.3%±2.64%,P<0.01)and the BE-LC-COPD group(45.6%±2.47%,P<0.01).Similar significant differences were observed for TLC,FRC,and DLCO.Microbiota community analysis revealed that the BE group was dominated by Staphylococcus and Veillonella,while the LC group was dominated by Haemophilus and Klebsiella.Groups with COPD co-occurrence showed lower microbial community diversity,with both Shannon and Simpson indices indicating lower mic

关 键 词：支气管扩张 肺癌 慢性阻塞性肺病 肺功能测试 微生物群落分析 

分 类 号：R563[医药卫生—呼吸系统]