慢性阻塞性肺疾病急性加重期住院患者呼吸道病毒病原学分布及危险因素分析

Prevalence and risk factors of viral infection in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease

目的探讨慢性阻塞性肺疾病急性加重(AECOPD)住院患者中的呼吸道病毒病原学分布及病毒感染的危险因素。方法纳入2012年05月-2015年05月因AECOPD住院的患者,采用聚合酶链式反应(PCR)检测各患者病毒感染情况,同时记录其基本资料、临床资料和住院时间等,应用Logistic回归分析探讨病毒感染相关危险因素。结果共收集AECOPD患者127例。PCR病毒检测阳性例数52例(40.94%),单一病毒感染患者36例(28.34%),双重病毒感染患者16例(12.60%)。病毒检测阳性组平均住院时间明显长于病毒检测阴性组[(11.5±0.96)d vs(8.99±0.42)d,P=0.001]。多因素Logistic回归分析显示吸烟(P=0.029)、糖尿病(P=0.001)、呼吸衰竭(P=0.049)、既往1年内急性加重次数(P=0.028)是AECOPD患者病毒感染的危险因素。结论 AECOPD住院患者呼吸道病毒感染率高。病毒感染使住院时间显著延长。吸烟、糖尿病、呼吸衰竭、既往1年内急性加重次数可能是COPD患者呼吸道病毒感染的重要危险因素,早期识别和防治有助于降低AECOPD发生率。

Objective To investigate the prevalence and risk factors of viral infection in the hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）. Methods A cross-sectional study was carried out which included the inpatients with AECOPD from May 2012 to May 2015. The basic information, clinical data and duration of hospital stay of every patient were collected, and the viral epidemiology was analyzed by means of PCR. A logistic regression analysis was performed to investigate the risk factors. Results A total of 127 AECOPD patients were included in this study. Among the 127 patients 52 patients（40.94%） got positive viral PCR results, of which 36 patients（28.34%） were one-virus positive and the others（12.60%） were two-virus positive. The AECOPD patients with viral infections had a longer hospital stay than those without viral infection [（11.5 ± 0.96） d vs（8.99 ±0.42） d, P = 0.001]. Multivariate regression analysis showed that smoking（P = 0.029）, diabetes（P = 0.001）,respiratory failure（P = 0.049）, and frequent exacerbation in the last year（P = 0.028） were the risk factors.Conclusions High prevalence of respiratory viral infection has been found in hospitalized patients with AECOPD.The duration of hospital stay is longer in virus-positive patients. Viral infection is associated with smoking, diabetes,respiratory failure, and exacerbations in the past year. Early identification and prevention of these risk factors may help to reduce the incidence of AECOPD.