慢性阻塞性肺疾病急性加重期患者呼吸道病毒分布及危险因素分析

Prevalence of respiratory viral infection and risk factors in 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期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)呼吸道病毒感染特点及危险因素。方法纳入2017年5月~2019年6月在徐州医科大学附属医院呼吸内科住院的患者。采用聚合酶链式反应(polymerase chain reaction,PCR)检测患者病毒感染情况,记录患者一般情况、合并症及实验室检查结果,应用Logistic回归分析探讨病毒感染的危险因素。结果共收集AECOPD患者107例。PCR病毒检测阳性例数41例(38.32%)。多因素Logistic回归分析显示,COPD急性加重患者病毒感染的危险因素为1年内急性加重次数(P=0.035)、烟草暴露(P=0.032)、糖尿病(P=0.001)、呼吸衰竭(P=0.075)四种因素。结论AECOPD患者呼吸道病毒感染以鼻病毒及流感病毒最为常见。AECOPD患者呼吸道病毒感染的重要危险因素是1年内急性加重次数、烟草暴露、糖尿病及呼吸衰竭,对于危险因素的识别及预防可降低AECOPD发生率。

Objective To investigate the characteristics and risk factors of respiratory virus infection in acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Patients hospitalized in the respiratory department of Affiliated Hospital of Xuzhou Medical University from May 2017 to June 2019 were included in this study.Polymerase chain reaction(PCR)was applied to detect the virus infection in patients,and the general situation,complications and laboratory test results were recorded.Logistic regression analysis was used to identify the risk factors of virus infection.Results A total of 107 patients with AECOPD were collected,of whom 41 cases(38.32%)were positively confirmed by PCR.Multivariate Logistic regression analysis showed that the risk factors of virus infection in COPD patients with acute exacerbation were acute exacerbation times in 1 year(P=0.035),tobacco exposure(P=0.032),diabetes mellitus(P=0.001),respiratory failure(P=0.075).Conclusion Rhinovirus and influenza virus are the most common respiratory virus infections in AECOPD patients.The key risk factors of respiratory virus infection in patients with AECOPD are the number of acute exacerbation in 1 year,tobacco exposure,diabetes and respiratory failure.The identification and prevention of risk factors may reduce the incidence of AECOPD.