肺炎支原体感染与慢性阻塞性肺病发病的相关性分析

Analysis on correlation between Mycoplasma pneumoniae infection and the pathogenesis of chronic obstructive pulmonary disease

目的探讨肺炎支原体(MP)感染与慢性阻塞性肺病(COPD)的相关性及急性加重期COPD患者(AECOPD)MP感染的易感因素。方法选取门诊2012年6月-2013年6月就诊的COPD患者124例为研究对象,根据患者病情分为COPD稳定期48例以及COPD急性加重期76例,选取100例健康体检者为对照组,采用免疫荧光法测定各组MP抗体。结果 COPD组患者MP-IgM、MP-IgG抗体阳性率显著高于对照组,而AECOPD组MP-IgM、MP-IgG抗体阳性率高于稳定期COPD组,差异有统计学意义(P<0.05)。AECOPD组中MP阳性感染患者咳嗽、发热、肺部罗音、心力衰竭、脓痰发生率显著高于MP阴性组,差异有统计学意义(P<0.05),而COPD稳定期患者MP(+)咳嗽、发热、肺部罗音、心力衰竭、脓痰发生率与MP(-)相比差异无统计学意义(P>0.05)。经单因素分析可知,导致AECOPD患者MP感染的易感的相关因素包括年龄、白细胞增加、合并肺心病、病程。结论 MP感染可能是引起COPD病情进展的重要原因,尤其对于年龄较大、合并肺心病、白细胞增加、病情较长的患者更容易感染MP。

Objective To explore the correlation between Mycoplasma pneumoniae （MP） infection and chronic obstructive pulmonary disease （COPD）,and to analyze the predisposing factors of acute exacerbation of COPD （AECOPD）.Methods A total of 124 outpatients with COPD from June 2012 to June 2013 were enrolled in the study.According to the patients＇ condition,they were divided into stable COPD group （n =48） and AECOPD group （n=76）.And 100 healthy volunteers were selected as control group.Irnmunofluorescent antibody test was used to detect antibodies to MP in the three groups.Results The positive rates of MP-IgM and MP-IgG in COPD group were significantly higher than those in control group,but the positive rates in COPD group were lower than those in AECOPD group,and the differencs were statistically significant （P 〈 0.05）.The incidence rates of cough,fever,pulmonary rales,heart failure,and purulent sputum in MP-positives were all significantly higher than those in MP-negatives in AECOPD group （P〈0.05）,but there were no significant differences in the incidence rates of cough,fever,pulmonary rales,heart failure,and purulent sputum between MP-positives and MP-negatives in COPD group （P 〉0.05）.The results of single factor analysis showed that age,leukocytosis,pulmonary heart disease,and duration were the factors that predisposed AECOPD patients to MP infection.Conclusions MP infection might be an important cause for the progression of COPD,and elderly patients with pulmonary heart disease,leukocytosis,and longer disease duration are more susceptible to MP infection.