结核感染对慢性阻塞性肺疾病患者肺部感染的影响评价

Evaluation of the effect of tuberculosis infections on pulmonary infections in chronic obstructive pulmonary disease patients

目的探究结核感染对慢性阻塞性肺疾病急性加重期(AECOPD)的影响,为降低肺部感染提供依据。方法对2012年1月-2013年6月145例慢性阻塞性肺疾病(COPD),因急性加重入院患者临床资料进行分析,根据AECOPD合并肺部结核感染分为观察组74例,未出现肺结核感染为对照组71例,对比两组患者白细胞(WBC)、中性粒细胞(N)、淋巴细胞(L)、C-反应蛋白(CRP)等感染指标,血红蛋白(Hb)、淋巴细胞计数(TLC)、血清白蛋白(ALB)、体质量指数(BMI)等营养指标以及其他临床症状。结果观察组的WBC、N、Hb、ALB及BMI均低于对照组,L、CRP、TLC高于对照组;观察组出现咯血、胸痛以及肺部感染等临床症状的分布率,分别为16.22%、10.81%、36.49%,高于对照组的2.82%、1.41%、5.63%;差异均有统计学意义(P<0.05)。结论伴有结核感染的AECOPD患者WBC、CRP等指标变化明显,并且临床上发生咯血等严重临床症状的概率更大。

OBJECTIVE To explore the effect of tuberculosis infections on acute exacerbation of chronic obstructive pulmonary disease（AECOPD）so as to provide reference for reducing pulmonary infections.METHODS Clinical data of 79 patients with chronic obstructive pulmonary disease（COPD）during Jan.2013 to Jun.2012 were analyzed.There were 145case-times of acute exacerbation of COPD.Patients were divided into the observation group of 74case-times（accompanied by pulmonary tuberculosis infections）and the control group of 71case-times（without pulmonary tuberculosis infections） by the presence of AECOPD complicated with pulmonary tuberculosis.The two groups of patients were compared for the infection indexes including white blood cell（WBC）,percentage of neutrophils（N）,percentage of lymphocytes（L）,C reactive protein（CRP）,etc.,and nutritive indexes including hemoglobin（Hb）,total lymphocyte count（TLC）,serum albumin（ALB）,body mass index（BMI）as well as other clinical symptoms.RESULTS The indexes of WBC,N,Hb,ALB and BMI were lower and the indexes of L,CRP,TLC were higher in the observation group than the control group.The distribution rates of clinical symptoms such as hemoptysis,chest pain and pulmonary infection were 16.22%,10.81%,and 36.49%in the observation group,higher than 2.82%,1.41%,and 5.63%in the control group.The differences were significant（P〈0.05）.CONCLUSION For AECOPD patients with tuberculosis infections,changes of indexes such as WBC and CRP are significant and the probability of the clinical occurrence of hemoptysis and other serious clinical symptoms is greater.