慢性阻塞性肺疾病急性加重患者呼吸道病毒及非典型病原体的检测分析

Detection and analysis of respiratory viruses and atypical pathogens in patients with acute exacerbation of chronic obstructive pulmonary disease

目的探讨呼吸道病毒及非典型病原体在慢性阻塞性肺疾病急性加重(AECOPD)患者中的感染情况及相互关系。方法采集2012年6月1日至2013年9月1日入住北京军区总医院呼吸内科的211例AECOPD患者血清标本,应用间接免疫荧光法(IFA)定性检测九种呼吸道病原体IgM抗体,并对检测结果进行分析。结果 AECOPD患者呼吸道病原体IgM抗体总阳性率为43.6%(92/211),2项以上混合阳性率为5.2%(11/211),其中以流感病毒A(FluA)最为多见;春季IgM抗体总阳性率显著高于夏季和秋季节,差异有统计学意义(P=0.001);春季FluA IgM抗体阳性率与夏季相比,差异有统计学意义(P=0.02)。不同年龄及年患病次数AECOPD患者IgM抗体阳性率比较,差异无统计学意义(P>0.05)。结论 AECOPD与呼吸道病毒及非典型病原体感染密切相关,尤其是流感病毒,在呼吸道病毒及非典型病原体流行的季节应做好预防工作。

Objective To explore the infections of respiratory viruses and atypical pathogens in patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） and their correlation. Methods A total of 211 serum samples were collected from patients with AECOPD in the Department of Respiration, General Hospital of Beijing Command from June 1,2012 to September 1,2013. Using the indirect immunofluorescence assay （ IFA ） detect IgM antibodies of nine types respiratory common pathogens and analysising the results. Results Positive rate of respiratory pathogens-IgM in patients with AECOPD was 43.6% , and mixed positive rate of two or more was 5.2% , in which FluA-IgM was the most common. The positive rate of pathogens-IgM in spring was higher than summer and autumn, the differences was statistically significant（P = 0. 001 ）. The highest positive rate season of FluA IgM was spring, there was statistical differences between spring and summer（ P = 0.02 ）. No obvious difference in positive rate of pathogens-lgM was found in different age groups and different frequency groups （ P 〉 0. 05 ）. Conclusions AECOPD with respiratory viruses and atypical pathogens are closely related, especially influenza virus. We should do preventive work well in epidemic-prone season of pathogens.