慢性阻塞性肺病患者肺炎衣原体感染临床分析

Chlamydia pneumoniae infection in patients with chronic obstructive pulmonary disease clinical analysis

目的 调查慢性肺炎衣原体（Cpn）感染和慢性阻塞性肺病（COPD）之间可能的相关性.方法 选取来我院就诊的COPD急性加重期患者60例,COPD稳定期患者40例,以及同期来院参加健康体检的老年人50例（对照组）,测定其第一秒用力呼气容积（FEV1）、用力肺活量（FVC）和圣乔治呼吸问卷（SGRQ）评分.用ELISA法检测Cpn抗体（IgA,IgG和IgM）.结果 COPD急性加重期患者的Cpn-IgM抗体检出率显著高于对照组（P＜0.01）,COPD急性加重期组和COPD稳定期组Cpn-IgA和IgG抗体的检出率均显著高于对照组（P＜0.01）.阿奇霉素治疗后所有COPD患者的临床症状均有显著改善：SGRQ记分和FEV1占预计值％显著增加,仅COPD急性加重期患者Cpn-IgM滴度显著下降（P＜0.01）.结论 慢性Cpn感染可能是COPD发展的危险因素.

Objective To investigate the possible association between chronic infection of Chlamydia pneumoniae（Cpn） and chronic obstructive pulmonary disease （COPD）.Methods Select to our hospital treatment in 60 patients with acute exacerbations of COPD,40 cases of patients with stable stage of COPD,as well as 50 cases of elderly people to participate in healthy physical examination to the same period（control group）,Determination of the FEV1,FVC and St.George Respiratory Questionnaire （SGRQ） score.Detection of Cpn antibody （IgA,IgG and IgM） by ELISA.Results The detection rate of Cpn-IgM in acute exacerbations of COPD group were significantly higher than the control group （P ＜ 0.01）,the detection rate of Cpn-IgA and Cpn-IgG in acute exacerbations of COPD and stable stage of COPD group were significantly higher than the control group（P ＜ 0.01）.After azithromycin treatment,the clinical symptoms of all patients with COPD were improved significantly.SGRQ scores and FEV1/Pre （％） were increased significantly,and meanwhile,only the titer of Cpn-IgM was decreased significantly （P ＜ 0.01） in acute exacerbations of COPD group.Conclusion The results suggest that chronic Cpn infection may be a risk factor for the development of COPD.