慢性阻塞性肺疾病患者肺炎衣原体感染的研究

Chlamydia pneumoniae infection in patients with 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 选择 6 1例COPD急性加重期患者 ,35例COPD稳定期患者 ,2 6名正常对照者 ,采用微量免疫荧光法测定血清肺炎衣原体特异性抗体IgA ,IgM ,IgG ,套式聚合酶链反应检测痰中的肺炎衣原体DNA。结果 COPD急性加重期患者的急性肺炎衣原体的感染率为 31 1% ,明显高于COPD稳定期和对照组 (P <0 0 5 )。COPD急性加重期组和稳定期组的慢性肺炎衣原体感染率分别为 2 1 3 %和 31 4% ,明显高于对照组(P均 <0 0 5 ) ,同时IgA的几何平均滴度在COPD急性加重期组中最高 (2 0 5 ) ,COPD稳定期组中次之(10 8) ,对照组最低 (3 6 ) ,三组间差异有显著性 (P <0 0 5 )。结论 急性肺炎衣原体感染为COPD急性加重的一个重要诱因 。

Objective To investigate the association of chlamydia pneumoniae infection with chronic obstructive pulmonary disease(COPD). Methods 61 patients with acute exacerbations of COPD,35 patients with stable COPD and 26 healthy subjects were selected Chlamydia pneumoniae specific serum IgG,IgA,IgM antibodies were measured by microimmunofluorescence method. Chlamydia pneumoniae DNA in sputum were detected by nested polymerase chain reaction. Results The prevalence of acute chlamydia pneumoniae infection in COPD patients with acute exacerbation was significantly higher (31 1%) than that in patients with stable COPD ( P <0 05) and in healthy subjects( P <0 01) The prevalences of chronic chlamydia pneumoniae infection in COPD patients with acute exacerbations(21 3%) and stable COPD patients (31 4%) were higer than that in healthy subjects ( P <0.05) The level of geometric mean titer of the serum IgA antibodies was the highest in COPD patients with acute exacerbations (20.5),intermediately elevated in stable COPD patients (10.8) and lowest in healthy subjects(3.6). Conclusion Acute chlamydia pneumoniae infection is a rather frequent event in acute excerbation of COPD,and chronic chlamydia pneumoniae infection may be involved in pathogenesis of COPD