稳定期慢性阻塞性肺疾病患者下呼吸道细菌定植与气道炎症相关性分析

Correlation analysis of lower respiratory tract bacterial colonization and airway infammafion in stable COPD patients

目的对稳定期慢性阻塞性肺疾病（SCOPD）患者行痰定量细菌培养及痰细胞分类计数，以探讨下呼吸道细菌定植（LABC）与气道炎症的相关性。方法选择SCOPD患者47例，通过痰诱导留取痰液，行痰定量细菌培养和痰细胞分类计数，并测定痰液及血清IL-8水平。结果下呼吸道细菌定植量高于10^7CFU／mL的患者共有13例。细菌定植量高于10^7CFU／mL的患者血清IL-8（70．65±19．89）pg／mL，痰液IL-8（364．65±74．19）pg/mL。显著高于细菌定植量低于10^7CFU／mL者的（15．87±3．01）pg/mL和（146．65±28．11）pg／mL，差异均有统计学意义（t=13．43、9．76，均P〈0．05）。随访1年，细菌载量≥10^7CFU／mL者，FEV。下降（0．071±0．016）L，显著高于细菌定植量低于10^7CFU／mL者，急性加重次数为（2．93±1．07）次，显著多于细菌定植量低于10^7CFU／mL者，其差异均具有统计学意义（t=5．43、6．54，均P〈0．05）。结论下呼吸道细菌定植可加重SCOPD患者的炎性反应，加重气流受限程度。

Objective To detect sputum quantitative bacterial culture and sputum cell counts in stable chronic obstructive pulmonary disease（SCOPD） patients, and explore the correlation between lower airway bacterial colonization（LABC） and airway inflammation. Methods 47 patients with SCOPD were chosen,all patients induced sputum specimens to sputum quantitative bacterial culture and sputum cell counts, sputum and serum IL-8 levels were also detected. Results There were 13 patients whose bacterial colonization of the lower respiratory tract in patients was higher than 107CFU/mL. Serum IL-8 levels of 13 patients was （ 70.65 ± 19.89 ） pg/mL, sputum IL-8 levels was （ 364.65 ±74.19 ） pg/mL, all significantly higher than those whose bacterial colonization of the lower respiratory tract lower than 107CFU/mL, （ 15.87 ±3.01 ） pg/mL and （ 146.65 ±28.11 ） pg/mL, there were statistically significant difference（t = 13.43,9.76,all P 〈0.05）. After 1-year follow-up,FEV1 decline（0.071 ±0.016） L in patients whose bacterial colonization of the lower respiratory tract ≥ 107CFU/mL, it was significantly higher than those whose bacterial colonization of the lower respiratory tract 〈 107CFU/mL; the frequency of acute exacerbation was （2.93 ±1.07 ） times, significantly more than those whose bacterial colonization of the lower respiratory tract 〈 107CFU/mL, the differences were statistically significant （ t = 5.43,6.54, all P 〈 0.05 ）. Conclusion Lower respiratory tract bacterial colonization in patients with SCOPD can aggravate the inflammatory response and increase degree of airflow limitation.