呼吸道病毒感染与慢性阻塞性肺疾病急性加重期患者肺功能的关系

Relationship between respirovirus infection and lung function of patients with acute exacerbation of chronic obstructive pulmonary disease

目的探讨呼吸道病毒感染与慢性阻塞性肺疾病急性加重期(AECOPD)患者肺功能的关系。方法 241例AECOPD患者,根据肺通气功能中1秒用力呼气容积占预计值百分比(FEV_1%)不同分为Ⅰ组(50%≤FEV_1%<80%)80例、Ⅱ组(30%≤FEV_1%<50%)80例及Ⅲ组(FEV_1%<30%)81例。应用蛋白芯片技术检测所有患者血清呼吸道合胞病毒(RSV)、柯萨奇病毒(COX)、流感病毒(Flu)、腺病毒(ADV)IgM,分析3组上述呼吸道病毒感染情况。结果 (1)241例患者中,呼吸道病毒抗体IgM阳性检出率为56.85%(137/241),在137例IgM阳性病例中,单一病毒感染阳性率、两种病毒混合感染阳性率、3种及其以上病毒混合感染阳性率分别为22.62%(31/137)、34.31%(47/137)、43.07%(59/137)。(2)在137例IgM阳性患者中,Ⅰ组占33例(24.09%),Ⅱ组占45例(32.85%),Ⅲ组占59例(43.06%),Ⅲ组IgM阳性率高于Ⅰ组(P<0.05)。Ⅰ组单一呼吸道病毒感染阳性率高于Ⅱ组、Ⅲ组(P<0.05),Ⅱ组两种混合感染阳性率高于Ⅰ组、Ⅲ组(P<0.05),Ⅲ组3种以上混合感染阳性率高于Ⅰ组、Ⅱ组(P<0.05)。(3)1秒呼气容积及1秒呼气容积占用力肺活量百分比均与呼吸道病毒混合感染数呈负相关(P均<0.001)。结论 AECOPD患者肺功能的受损程度可能与呼吸道感染有关,AECOPD患者肺功能越差,混合感染率越高。

Objective To investigate the relationship between respirovirus infection and lung function of patients with acute exacerbation of chronic obstructive pulmonary disease（ AECOPD）. Methods According to the forced expiratory volume in one second/predicted value ratio（ FEV1%）,241 patients with AECOPD were divided into GroupⅠ（ 50% ≤FEV1% 〈80%,n = 80）,GroupⅡ（ 30% ≤FEV1% 〈50%,n = 80） and Group Ⅲ（ FEV1% 〈30%,n = 81）. Protein chip technology was used to detect the serum IgMs of respiratory syncytial virus（ RSV）,Coxsackie virus（ COX）,influenza（ Flu） and adenovirus（ ADV）,then the infection of respirovirus mentioned above was analyzed in the three groups. Results（ 1） The positive detection rate of respirovirus antibody IgM was 56. 85%（ 137/241） in 241 patients. In the 137 IgM-positive cases,the infection rates of single virus,two types of virus,three or more than three types of virus were 22. 62%（ 31/137）,34. 31%（ 47/137） and 43. 07（ 59/137） respectively.（ 2） Of 137 IgM-positive cases,33（ 24. 09%）,45（ 32. 85%） and 59（ 43. 06%）cases were founded in Group Ⅰ,Group Ⅱ and Group Ⅲ respectively. The positive rate of IgM in Group Ⅲ was higher than that in GroupⅠ（ P〈0. 05）. The infection rate of single respirovirus in Group Ⅰ was higher than those in Group Ⅱ and Group Ⅲ（ P〈0. 05）,the poly infection rate of two types of virus in Group Ⅱ was higher than those in Group Ⅰ and Group Ⅲ（ P〈0. 05）,and the poly infection rate of three or more than three types of virus in Group Ⅲ was higher than those in GroupⅠand Group Ⅱ（ P〈0. 05）.（ 3） The forced expiratory volume in one second and the forced expiratory volume in one second to the forced vital capacity ratio negatively correlated with the numbers of respirovirus poly infection（ all P〈0. 001）. Conclusion The impairment of lung function in AECOPD patients may be related to respirovirus infection. The poly infection rate is higher in the patients with poorer lung function.