成人支气管哮喘患者咽拭子支原体筛查及阳性患者临床特点分析

Pharyngeal swab mycoplasma screening of adult bronchial asthma patient and analysis of the clinical characteristics of the positive patients

目的观察成人支气管哮喘（简称哮喘）患者咽拭子支原体阳性率，并对支原体阳性患者临床特征进行分析，从而探讨支原体感染与哮喘的相关性。方法选择潍坊哮喘病医院2012年1月至2012年12月入院的成人哮喘患者，对其进行咽拭子肺炎支原体培养，观察其阳性率，与健康成人及同期住院或门诊的儿童哮喘患者支原体阳性率进行比较，并从血常规、皮质醇、肺功能、哮喘控制测试（ACT）评分、鼻炎症状评分等方面分析成人肺炎支原体阳性哮喘患者的临床特点。结果503例成人哮喘患者中有345例咽拭子支原体培养阳性，阳性率为68．59％，与儿童组（阳性率为71．54％）比较差异无统计学意义，但高于健康对照组，差异有统计学意义。支原体阳性患者与阴性患者相比较，前者外周血嗜酸粒细胞比例及鼻炎症状评分高于后者，两组之间差异有统计学意义，ACT评分、FEV1、FEV1％pred、皮质醇水平均低于后者，两组之间差异有统计学意义。所有成人哮喘患者中，有139例确诊为变应性鼻炎，其中支原体阳性患者109例，阴性患者30例；有106例确诊为鼻一鼻窦炎，其中支原体阳性患者89例，阴性患者17例，支原体阳性组与阴性组相比，变应性鼻炎及鼻-鼻窦炎的患病率明显增高，两组比较差异有统计学意义。结论肺炎支原体感染在哮喘的发病中具有重要作用，肺炎支原体感染可加重哮喘患者的临床症状，可能是哮喘患者临床症状长期不缓解或成为难治性哮喘的重要原因，肺炎支原体感染与变应性鼻炎及鼻-鼻窦炎的发病密切相关。

Objective Observes the positive rate of swab mycoplasma in adult bronchial asthma （asthma） patients, to discuss the relevance of mycoplasma pneumoniae infection and asthma by analyse the clinical characteristics of positive patients. Methods Chose all the adult inpatients with asthma of Weifang Asthma Hospital from Jan. 2012 to Dec. 2012. Cultured the mycoplasma pneumoniae of throat swab,observed their positive rates, compared with the healthy adults, children inpatient and outpatient with asthma over the same period, analysed the clinical feature of adult patients with mycoplasma pneumoniae-positive from blood routine examination, cortisol, lung function, ACT score, rhinitis symptom scores. Results Three hundred and forty-five cases of all the 505 patients were positive,the positive rate was 68.59 %. The positive rate had no statistically significant difference compared with children series,but higher than that of healthy controls, the difference was statistically significant. Compared with mycoplasma negative patients, the Peripheral blood eosinophilic granulocyte ratio and rhinitis symptom scores of mycoplasma positive patients were higher, there were signifcant difference between the two groups;the ACT score, FEV1 % pred, FEV1, cortisol were lower, there were signifcant difference between the two groups. One hundred and thirty-nine cases diagnosed as allergic rhinitis, with 109 cases patients with myeoplasma positive,30 patients with mycoplasma negative. There are 106 cases diagnosed as nasal sinusitis,including 89 cases of mycoplasma positive patients, 17 patients with mycoplasma negative, compared the positive group with negative group,the prevalence of allergic rhinitis and nasal sinusitiswas had statistically higher,the differences has statistical significance. Conclusions Mycoplasma pneumoniae infection has an important role in the pathogenesis of bronchial asthma. The infection of mycoplasma pneumoniae may aggravate the clinical symptoms of bronchial asthma patient. Part of the asthma patientsts clinical symptoms do not alleviate for a long time,or change into refractory asthma. Possibly, mycoplasma pneumoniae infection is an important reason. Mycoplasma pneumoniae infection and allergic rhinitis and allergic rhinitis were closely related.