慢性阻塞性肺疾病急性加重期患者的腺病毒感染及基因特征分析

Infection status and genetic characteristics of adenovirus in patients with acute exacerbation of chronic obstructive pulmonary disease

目的了解慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者的呼吸道病毒感染情况及腺病毒感染特点。方法收集2020年11月至2021年4月安徽省蚌埠市某三甲医院AECOPD住院重症患者咽拭子,采用实时荧光定量PCR(qPCR)方法筛查16种常见呼吸道病毒,对腺病毒(ADV)阳性样本扩增腺病毒六邻体基因,构建进化树。结果AECOPD患者呼吸道样本中呼吸道病毒检出率为38.38%(109/284),其中,ADV检出率最高,为27.81%(79/284)。重症患者ADV感染以C1型为主,同时,有B、C和D等多个亚型存在。结合临床数据,AECOPD患者中,感染ADV的较未感染ADV的病程长、预后差。结论临床应对AECOPD患者的呼吸道病毒感染情况进行有效监测,以提高诊断和治疗效果。

Objective To investigate the respiratory tract virus infection and the characteristics of adenovirus infection in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods From November 2020 to April 2021,throat swabs from the severe patients with AECOPD in a classⅢhospital in Bengbu,Anhui province,were collected.Real-time fluorescent quantitative PCR(qPCR)was used to detect 16 common respiratory viruses,including adenovirus(ADV).The hexon genes of ADV were amplified followed with the phylogenetic analysis.Results The detection rate of respiratory viruses was 38.38%(109/284),and the detection rate of ADV was highest(27.81%,79/284)in these AECOPD patients.ADV infection was mainly caused by subtype C1 virus,and there were multi subtypes such as B,C and D.Combined with clinical data,the AECOPD patients infected with ADV had a longer course of disease and poorer prognosis compared with the AECOPD patients without ADV infection.Conclusion Effective monitoring of respiratory virus infection in AECOPD patients should be carried out in clinical practice to improve the clinical diagnosis and treatment.