摘要
目的 研究慢性阻塞性肺疾病 (COPD)老年患者的痰细菌学特征、细菌感染与肺功能的关系。 方法 对 6 7例住院COPD急性加重期老年患者行痰细菌定量培养、X线胸片和肺功能检查。 结果 检测痰样 5 6 8份 ,共分离出 2 3种 36 0株病原菌。 48例痰培养出致病菌 ,阳性分离率 71 6 %。最常见的致病菌为革兰阴性杆菌 ,占6 5 8% (2 37/5 6 8)。其次为念珠菌 ,占 2 0 6 % (74/5 6 8)。革兰阳性球菌仅占 13 6 % (49/5 6 8)。肺功能FEV1%预计值<35 %时 ,其人均细菌感染株数为 9 46 ,而FEV1%预计值为 35 %～ 49%时 ,其人均细菌的感染株数为 6 5 3。FEV1%预计值为 5 0 %～ 75 %时 ,其人均细菌感染株数为 3 2 3(P <0 0 1)。 结论 肺功能减退程度与感染致病菌株机会呈正比 ,肺功能越差越易引起致病菌的感染 ,痰细菌培养阳性率越高。提示COPD患者急性感染加重时 ,细菌病因学、肺功能均与疾病的严重程度密切相关。
Objective The aim of this study was to evaluate the relationship between decrease of lung function and the sputum culture in acute exacerbation of elderly COPD. Methods Sixty-seven elderly patients admitted to our hospital with an acute infective exacerbation of COPD were investigated with the clinical data,chest film,lung function test and sputum bacteria culture.The patients were categorized according to the recently published three stages of severity.Lung function tests revealed an FEV 1 of 50% to 75% of the predicted value in 35 patients(group C),an EFV 1 of 35% to 49% of the predicted value in 19 patients(group B),and an FEV 1 of<or=35 of the predicted value in 13 patients(group A). Results The sputum cultures were positive in 48 of 67 cases.The positive rate of culture in discovering microorganisms were about 71 6%(48/67).For all patients together,the most frequently isolated bacteria were Gram-negative bacilli(65 8%,237/568),followed by Candida albicans(20 6%,74/568),and Gram-positive cocci(13 6%,49/568).In group A patients,10 of 13 displayed bacteria.In group B patients,14 of 19 showed bacteria.In group C patients,24 of 35 presented bacteria.The average number of becteria per patient from group A,group B and group C was 9 46,6 53 and 3 23,respectively ( P <0 01). Conclusions There is a correlation between deterioration of lung function and the bacteria isolated from patients with acute infective exacerbation of COPD.The more impairment of lung function,the more chance of bacteria infection,the more positive rate of sputum culture.
出处
《实用老年医学》
CAS
2000年第4期203-205,共3页
Practical Geriatrics
关键词
慢性阻塞性肺疾病
急性加重期
细菌学
肺功能
Chronic obstructive pulmonary disease Acnte infective exacerbation Etiologic bacteria Lung function
