摘要
目的探讨慢性阻塞性肺疾病(COPD)急性加重期患者痰菌群状态以及与炎症细胞因子、肺功能等临床指标之间的相关性。方法回顾性选取山东大学中西医结合医院肺病科2021年5月至2022年5月收治的88例COPD急性加重期患者作为研究组,根据患者病情严重程度分为四个亚组,Ⅰ组、Ⅱ组、Ⅲ组、Ⅳ组各22例,并选取同期22例健康志愿者作为对照并纳入常规组,均行痰菌培养,比较各组革兰阴性杆菌、革兰阳性杆菌的检出率,并分析痰菌培养结果与炎症细胞因子[CRP(C反应蛋白)、IL-6(白细胞介素-6)、IL-8(白细胞介素-8)、TNF-α(肿瘤坏死因子-α)]、肺功能指标[FEV_(1)(第1 s用力呼气量)、FEV_(1)/FVC(第1 s用力呼气量/用力肺活量)]之间的相关性。结果研究组革兰阴性杆菌株、革兰阳性杆菌株多于常规组,差异有统计学意义(P<0.05),且研究组内Ⅳ组革兰阴性杆菌株、革兰阳性杆菌株检出数高于Ⅲ组、Ⅱ组、Ⅰ组,差异有统计学意义(P<0.05)。Ⅰ组CRP、IL-6、IL-8、TNF-α低于Ⅱ组、Ⅲ组、Ⅳ组,差异有统计学意义(P<0.05),Ⅰ组FEV_(1)、FEV_(1)/FVC高于Ⅱ组、Ⅲ组、Ⅳ组,差异有统计学意义(P<0.05)。COPD急性加重期革兰阴性杆菌株数、革兰阳性杆菌株数与CRP、IL-6、IL-8、TNF-α呈正相关(P<0.05),与FEV_(1)、FEV_(1)/FVC呈负相关(P<0.05)。结论COPD急性加重期致病菌以革兰阴性杆菌为主;患者病情越严重,致病菌株数量就越多;COPD急性加重期患者痰菌培养结果与炎症细胞因子表达、肺功能密切相关。
Objective To explore the relationship between sputum flora status and inflammatory cytokines,lung function and other clinical indicators in patients with acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods The clinical data of 88 patients with acute exacerbation of COPD admitted to the Department of Pulmonary Diseases of Ji'nan Hospital of Integrated Traditional Chinese and Western Medicine from May 2021 to May 2022 were retrospectively selected asd research objects,according to the severity of the disease,the patients were divided into four subgroups,groupⅠ,groupⅡ,groupⅢand groupⅣwith 22 cases in each group.At the same time,22 healthy volunteers were selected as the control group and included in the conventional group,and all underwent sputum culture.The detection rates of gram-negative and gram-positive bacilli in each group were compared.And analyze the results of sputum culture and inflammatory cytokines(CRP[C-reactive protein],IL-6[interleukin-6],IL-8[interleukin-8],TNF-α[tumor necrosis factor-α]),correlation between lung function indexes(FEV_(1)[forced expiratory volume of 1 s],FEV_(1)/FVC[forced expiratory volume of 1 s/forced vital capacity]).Results The number of gram-negative bacilli and gram-positive bacilli in the study group were higher than those in the conventional group,the differences were statistically significant(P<0.05).The number of gram-negative bacilli and gram-positive bacilli in groupⅣwere higher than those in groupⅢ,groupⅡand groupⅠ,the differences were statistically significant(P<0.05).CRP,IL-6,IL-8,TNF-αin groupⅠwere lower than those of groupⅡ,groupⅢand groupⅣ,the differences were statistically significant(P<0.05).FEV_(1)and FEV_(1)/FVC in groupⅠwere higher than those in groupⅡ,groupⅢand groupⅣ,the differences were statistically significant(P<0.05).The number of gram negative bacilli,gram positive bacilli in acute exacerbation of COPD were positive correlation with CRP,IL-6,IL-8,TNF-α(P<0.05),and were negative correlation with FEV_(1)and FEV_(1)/FVC(P<0.05).Conclusion Gram-negative bacilli are the main pathogenic bacteria in acute exacerbation of COPD.The sicker the patient,the more pathogenic strains.The results of sputum culture in patients with acute exacerbation of COPD are closely related to the expression of inflammatory cytokines and lung function.
作者
李秋荣
LI Qiurong(Department of Pulmonary Diseases,Ji'nan Hospital of Integrated Traditional Chinese and Western Medicine,Shandong Province,Ji'nan271100,China)
出处
《中国当代医药》
CAS
2023年第3期22-25,共4页
China Modern Medicine
关键词
慢性阻塞性肺疾病
急性加重期
痰菌培养
炎症细胞因子
肺功能
Chronic obstructive pulmonary disease
Acute exacerbation
Sputum culture
Inflammatory cytokines
Lung function
