肺炎衣原体感染与慢性阻塞性肺疾病的相关性分析

Correlation between Chlamydia pneumoniae infection and chronic obstructive pulmonary disease

目的探讨肺炎衣原体感染与慢性阻塞性肺疾病（COPD）的相关性。方法2010年8月至2012年5月选择江阴市人民医院呼吸内科住院或门诊就诊的82例COPD急性加重期（AE—COPD）患者和稳定期COPD患者46例，对照组为38名健康志愿者。住院患者于人院第2天、急诊患者于就诊当日采静脉血2ml，并于人院15d时采取第2份静脉血，分离血清冷冻保存采用微量免疫荧光测定肺炎衣原体抗体（IgG、IgM、IgA）。结果三组人群IgG阳性率的差异无统计学意义（P〉0．05）；AE．COPD组IgG的几何平均滴度（GMT）明显高于对照组（P〈0．01）；三组人群IgA阳性率以AE—COPD组最高，但与稳定期COPD组比较的差异无统计学意义（P〉0．05），该两组与对照组比较差异均有统计学意义（P〈0．01）；AE．COPD组与稳定期COPD组IgA的GMT比较差异有统计学意义（P〈0．05），该两组与对照组比较差异均有统计学意义（P〈0．05，P〈0．01）；AE—COPD组急慢性感染率与对照组比较差异有统计学意义（P〈0．05），稳定期COPD组急慢性感染率与对照组比较差异无统计学意义（P〉0．05）。结论肺炎衣原体感染可能与COPD的发展密切相关。

Objective To investigate the correlation between Chlamydia pneumonia （Cpn） infection and chronic obstructive pulmonary disease （COPD）. Methods 82 patients with acute exacerbation COPD （AE-COPD） or stabilized COPD patients at outpatient visits, in the People＇ s Hospital of Jiangyin city from Aug. 2010 to May 2012, together with 46 cases having stationary phase COPD and 38 healthy volunteers as control group, were involved in this study. Patients were bled 2 ml, on the next day of hospitalization while patients at emergency room were bled 2 ml immediately, but bled again on the 15th day. Serum was separated through cryopreservation and the Cpn antibodies （IgG, IgM and IgA antibodies） were detected, under micro-immunofluorescence. Results In terms of IgG in the three groups, the positive rates did not show significant differences （P〉0.05） but the GMT of the IgG in the AE-COPD group was significantly higher （P〈0.01） than that in the control group. IgA positive rate among the three groups; AE-COPD appeared the highest. There was no significant difference between the AE-COPD group and stationary phase COPD group （P〉0.05）, however, there were significant differences between the AE-COPD group, the stationary phase COPD group and the control group （P〈0.01）. In terms of GMT of IgA in the three groups, there was significant difference between the AE-COPD group and stationary phase COPD group （P〉 0.05）, but with significant difference between the AE-COPD group and the control group （P〉0.01）. There was significant difference between stationary phase COPD group and the control group （P〉 0.05）. When comparing both the rates of acute infection and chronic infection on the AE-COPD groups with the control group, there appeared significant differences （P〈0.05, P〈0.01）. When comparing the acute and chronic infection between the stationary phase COPD group and the control group, the rate of acute infection did not show significant difference （P〉0.05） while the chronic infection rate appear to have had significant difference （P〈0.01）. Conclusion Cpn infection seemed to be closely related to the development of COPD.