慢性阻塞性肺疾病急性加重患者常见病毒感染分析

Analysis of common viral infections found in patients with chronic obstructive pulmonary disease with acute exacerbations

目的 分析慢性阻塞性肺疾病（Chronic obstructive pulmonary disease,COPD）急性加重期患者感染病毒特点,及病毒感染在COPD急性加重中的作用.方法 将武警四川省总队医院2015年4月-2016年3月收治的COPD急性加重期患者193例为A组,同期COPD稳定期患者50例为B组.检测两组患者呼吸道合胞病毒、腺病毒、副流感病毒、甲型流感病毒、乙型流感病毒的IgM抗体.结果 两组患者在年龄、性别、病程方面差异无统计学意义（P＞0.05）.A组病毒感染率13.47％,高于B组（Х^2=5.29,P＜0.05）.A组感染的病毒以乙型流感病毒最多见（感染率12.44％）,之后依次为甲型流感病毒（感染率7.78％）、副流感病毒（感染率7.25％）、腺病毒（感染率2.63％）、呼吸道合胞病毒（感染率1.32％）.单一病毒感染占COPD急性加重期感染病毒患者的34.6％,2种病毒感染占15.4％,3种或3种以上病毒感染占50％.夏秋季病毒感染率高于冬春期,但差异无统计学意义（P＞0.05）.结论 COPD急性加重患者有13.47％存在病毒感染,且大部分为2种或2种以上病毒感染,病毒感染可能在COPD急性加重中起重要作用,需重视COPD患者病毒感染的预防和治疗.

Objective To analyze characteristics of virus infections in patients with acute exacerbations of chronic obstructive pulmonary disease （COPD）,and to analyze the role of virus infection in acute exacerbations of COPD.Methods Totally 193 patients of COPD with acute exacerbations admitted to the Hospital of Sichuan Provincial Armed Police Force from April 2015 to March 2016 were enrolled as group A,and 50 patients of COPD in stable stage in the same period were enrolled as group B.IgM antibodies to respiratory syncytial virus,adenovirus,parainfluenza virus,influenza A virus,and influenza B virus in two groups were detected.General conditions and total virus infection rate were analyzed.Infection rates of each virus in group A were calculated.Proportion of single virus infection,two virus infections and several virus infections in group A with virus infection were calculated.Virus infection rates in different seasons in group A were also analyzed.Results There was no significant difference in age,sex,and course of disease between the two groups（P 〉 0.05）.The virus infection rate of group A was 13.47%,which was higher than that of group B（Х^2 =5.29,P 〈 0.05）.The most common virus found in group A was influenza B virus （infection rate 12.44%）,followed by influenza A virus （infection rate 7.78%）,parainfluenza virus （infection rate 7.25%）,adenovirus （infection rate 2.63%）,respiratory syncytial virus （infection rate 1.32%）.Single virus infection accounted for 34.6% of acute exacerbation COPD patients with virus infection,and two virus infections accounted for 15.4%,and three or more virus infections accounted for 50%.Virus infection rate in summer and autumn were higher than that in winter and spring,but the differences were not statistically significant（P 〉 0.05）.Conclusions This study showed that 14.37% of patients with acute exacerbations of COPD had viral infections,and most of them were infected with two or more viruses.Virus infection may play an important role in the acute exacerbation of COPD,and we need to pay attention to the prevention and treatment of virus infection in patients with COPD.