鼻病毒对慢性阻塞性肺疾病急性加重期的作用

Effects of rhinovirus on acute exacerbation of chronic obstructive pulmonary disease

目的探讨鼻病毒在慢性阻塞性肺疾病急性加重期(AECOPD)的作用。方法纳入就诊于医院呼吸内科的AECOPD患者90例。收集患者咽拭子,采用PCR法行鼻病毒检测,并测定鼻病毒滴度及白细胞计数。结果鼻病毒感染的AECOPD患者与无鼻病毒感染的AECOPD患者年龄、性别、体重指数(BMI)差异无统计学意义(P>0. 05),而吸烟率、肺功能、白细胞计数、慢性肺心病、呼吸衰竭及肺性脑病发生率间差异有统计学意义(P <0. 05),单因素Logistics分析得出性别、吸烟、发热及鼻病毒感染是AECOPD的危险因素,多因素Logistics分析结果显示鼻病毒感染是AECOPD的独立危险因素[Or=11. 20,P=0. 023,95%CI(8. 766,14. 309)],相关性分析和散点图结果显示AECOPD鼻病毒滴度与白细胞计数(r=0. 790,P=0. 000)和吸烟指数(r=0. 724,P=0. 000)均显著相关。结论鼻病毒感染是AECOPD的独立危险因素,症状加重可能与其刺激机体产生炎性反应有关,预防鼻病毒的感染为临床减缓AECOPD的病情进展提供了一种新的手段。

Objective To explore the effects of rhinovirus on acute exacerbation of chronic obstructive pulmonary disease(COPD).Methods A total of 900 patients with AECOPD who were admitted and treated in our hospital from March 2014 to March 2016 were enroled in the study.The specimens of throat swabs of patients were collected and were detected by PCR for rhinovirus,and virus titer and white blood cell count were measured.Results There were no significant differences in age,sex and body mass index(BMI)between the COPD acute exacerbation patients with rhinovirus infection and those without rhinovirus infection(P>0.05),however,there were significant differences in smoking rate,chronic pulmonary heart disease,lung function,white blood cell count,respiratory failure and pulmonary encephalopathy rates between the two groups(P<0.05).Single factor logistics analysis showed that gender,smoking,fever and rhinovirus infection were risk factors of acute exacerbation of COPD.Multivariate regression logistics analysis showed that rhinovirus infection was a risk factor of acute exacerbation of COPD[r=11.20,P<0.05,95%CI(8.766,14.309)],and the correlation analysis showed that rhinovirus infection was significantly associated with white blood count(r=0.79,P<0.01)and smoking(r=0.724,P<0.01)in acute exacerbation of COPD.Conclusion Rhinovirus infection is an independent risk factor of acute exacerbation of COPD.The aggravated symptoms may be related to the inflammatory reaction that stimulates body to produce inflammatory reaction.The prevention of rhinovirus infection provides an new means for relieveing clinical symptoms of acute exacerbation of COPD.