84例慢性阻塞性肺病患者咽部寄殖菌的改变

The Change of Oropharyngeal Bacterial Colonization in Hospitalized Patients with Chronic Obstructive Pulmonary Disease

对８４例慢性阻塞性肺病（ＣＯＰＤ）住院患者作了２５３次咽拭子细菌培养，以观察咽部寄殖菌的改变，结果显示，入院时卡他摩拉菌分离率最高（８８．１％），住院期间下降（５１．２％，Ｐ＜０．００１）；革兰阴性杆菌总的分离率住院期间明显高于入院时（分别为４０．８％和１４．３％，Ｐ＜０．０１），其中以绿脓杆菌最突出（１８．５％）。从时间来看，住院第４周时与第２周时相比较，卡他摩拉菌降低及革兰阴性杆菌增加明显（Ｐ＜０．０１）。住院期间加用激素组革兰阴性杆菌、白色念珠菌、金葡菌分离率明显高于未用激素组（Ｐ＜０．０１）。

To survey the change of oropharyngeal bacterial colonization in hospitalized patients with chronic obstructive pulmonary disease (COPD),pharyngeal bacterial culture was performed for 252 times in 84 patients, The results showed that the isolation rate for Moraxella catarrhalis, was highest (88.1%) in admission, compared with 51.2% during hospitalization (P<0.001); the total isolation rate for gram-negative bacilli during hospitalization was much higher than that in admission(40.8%, 14.4% respectively, P<0.001), the isolation rate for Pseudomonas aeruginosa ranked first (18.5%). To compare the fourth week during hospitalization with the second week, the decrease of the isolation rate for Moraxella catarrhalis and the increase of that for gram-negatie bacilli were very outstanding (P<0.001). The isolation rates for gram-negative bacilli, Candida albicans, or Staphylococcus aureous in patients who used steroid hormone during hospitalization were much higher than that in patients who did not used steroid hormone (P<0.01).