支气管扩张症和下呼吸道菌群的研究进展

Research progress on bronchiectasis and lower respiratory tract flora

由于基于分子手段的非培养技术的应用,"肺无菌"这一传统观念已被彻底推翻,下呼吸道存在和上呼吸道同源、生物量较低的菌群。细菌定植是非囊性纤维化支气管扩张症恶性循环假说的重要环节,其中铜绿假单胞菌是导致支气管扩张症加重的重要病原菌。本文总结了下呼吸道菌群的概况、支气管扩张症稳定期和加重期及抗生素应用与下呼吸道菌群的关系,希望对支气管扩张症的防治有一定启发。

With culture-independent DNA-based molecular techniques, the dogma “lung is sterile” has been overturned thoroughly. The lower respiratory tract has flora with lower biomass which is homologous to the upper respiratory tract. Bacteria colonization plays an important role in the “vicious cycle” of non-cystic fibrosis bronchiectasis, and pseudomonas aeruginosa is associated with the exacerbation of bronchiectasis. Oral and inhalant antibiotics are commonly used clinically, but macrolide maintenance therapy could significantly lead to the increase of macrolide-tolerant organisms. So we try to summarize the profile of lower respiratory tract flora, and the relationship between the bronchiectasis stable and exacerbated periods and the lower respiratory tract flora, hoping to provide enlightenment for the prevention and treatment of the bronchiectasis.