呼吸道病原体九联检与痰培养联合应用在慢性阻塞性肺疾病急性加重期中的价值研究

Study on the Value of Combined Application of Exacerbation in Nine Respiratory Pathogens Test and Sputum Culture in Chronic Obstructive Pulmonary Disease

目的：探讨AECOPD患者呼吸道病原体九联检与痰培养联合检测临床中的应用研究。方法选取我院2012年10月～2014年5月157例慢性阻塞性肺疾病急性加重期患者为研究对象，留取患者血清及痰标本进行呼吸道病原体九联检与痰培养两种检验方法进行联合检测，以分析两种方法的病原菌检测情况。结果痰培养法分离出其中157例AECOPD患者痰标本172株病原菌，前6种主要病原菌，分别为土生克雷伯菌、肺炎克雷伯菌，铜绿假单胞菌，大肠埃希菌，以及表皮葡萄球菌与真菌，构成比分别为24.4%、19.8%、15.1%、12.2%、11.6%、6.9%；同时抽取患者血清对其进行九联检法检测，分别为肺炎支原体、肺炎衣原体、Q热立克次体、呼吸道合胞病毒、腺病毒、嗜肺军团菌1型、流感病毒甲型、流感病毒乙型、副流感病毒1、2、3型，构成比分别为13.4%、1.3%、0.6%、6.4%、3.1%、8.2%、7.0%、5.0%、5.7%。病原体检测阳性率为71.9%（113/157），其中痰检细菌阳性率为43.3%；非典型病原体阳性率为23%；病毒检测阳性率为27.4%；细菌和非典型病原体均为阳性29例，阳性率为18.5%；细菌和病毒均为阳性21例，阳性率为13.4%。结论对于AECOPD患者采取呼吸道九联检与痰培养联合检测可以有效地提高病原微生物诊断效果，采用间接免疫荧光法快速检测人血清中9种呼吸道感染主要病原体的IgM抗体，可为临床的诊断和治疗提供参考依据，能够全面地对感染病原菌进行分析，给予患者合理的治疗，同时，呼吸道感染病原体九联检查法的操作也比较简单。

ObjectiveDiscussion about AECOPD patients with respiratory pathogens in nine test and sputum culture study on the combined detection in clinical application.Methods In our hospital from 2012 October to 2014 May, 157 patients with chronic obstructive pulmonary disease with acute exacerbation of patients as the research object, the serum and sputum specimens of nine patients with respiratory tract pathogens test and sputum culture of two testing methods were combined to pathogenic bacteria detection, detection and analysis of two methods.Results Sputum culture were isolated including 157 cases of AECOPD patients with sputum specimens of 172 strains of pathogenic bacteria, the former 6 kinds of main pathogenic bacteria, were klebsiella terrigena, klebsiella pneumoniae, pseudomonas aeruginosa, escherichia coli, and staphylococcus epidermidis and fungi, the constituent ratio respectively is 24.4%, 19.8%, 15.1%, 12.2%, 11.6%, 6.9%; also in serum of patients with extraction of nine test for its detection, respectively, mycoplasma pneumoniae, chlamydia pneumoniae, Q Gerickettsy, Respiratory Syncytial Virus, Adenovirus, Legionella Pneumophila Type 1, Inlfuenza A, Inlfuenza B Virus, Parainlfuenza Virus 1, 2, 3 type, Constituent ratio is 13.4%, 1.3%, 0.6%, 6.4%, 3.1%, 8.2%, 7%, 5%, 5.7%. The positive rate of pathogens was 71.9% （113/157）, of which the positive rate of bacteria in sputum examination was 43.3%, the positive rate of atypical pathogens was 23%; the positive rate of virus detection was 27.4%; Bacteria and atypical pathogens were positive in 29 cases, the positive rate was 18.5%; Bacteria and virus were positive in 21 cases, the positive rate was 13.4%.Conclusion For AECOPD patients to take nine test and respiratory tract sputum Culture joint detection can effectively improve the effect of diagnosis of pathogenic microorganisms, rapid detection of IgM antibody of main pathogens in 9 respiratory tract infection in Human Serum by Indirect immunolfuorescence Method, it can provide a reference for clinical diagnosis and treatment, to a comprehensive analysis of infection pathogens, Give treatment patients with reasonable, at the same time, the inspection method of respiratory tract infection pathogens unit operation is relatively simple, suitable for application in primary hospital..