慢性阻塞性肺疾病频繁急性加重与合并呼吸衰竭对呼吸道微生态的影响

The impact of COPD with frequent acute exacerbation and respiratory failure on microbiology in the respiratory tract

目的探讨慢性阻塞性肺疾病(简称慢阻肺)频繁急性加重与合并呼吸衰竭患者呼吸道微生态的特点。方法选取2021年11月—2022年3月在贵州省人民医院呼吸与危重症医学科住院诊断为慢阻肺急性加重患者60例,随机分为两对亚组,第一对亚组为慢阻肺非频繁急性加重组及频繁急性加重组,第二对亚组为慢阻肺急性加重并呼吸衰竭组及不并呼吸衰竭组,使用16S rRNA高通量测序方法对患者进行痰微生态检测,比较各亚组Alpha、Beta多样性、细菌构成及相对丰度的差异。结果慢阻肺非频繁急性加重组细菌微生态多样性、丰度均高于频繁急性加重组;慢阻肺急性加重并呼吸衰竭组细菌微生态多样性低于慢阻肺急性加重不并呼吸衰竭组,但丰度高于不并呼吸衰竭组。结论慢阻肺频繁急性加重与合并呼吸衰竭与气道微生态变化相关,在病情变化中起到重要作用。

Objective To investigate the characteristics of micro-biology in the respiratory tract in the patients who were suffering acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with/without their respiratory failures as well as with the high/low frequency of exacerbation.Methods Sixty confirmed subjects in the Department of Respiratory and Critical Care in Guizhou Provincial Hospital from Nov.2021 to Mar.2022 were chosen and then divided them into two pairs of sub-groups randomly.Sub-group pairs one were based on the frequency of AECOPD:higher frequency and lower frequency.Sub-group pairs two were based on whether the patients were once with respiratory failure or not.16S rRNA high-throughput sequencing method was used to detect sputum microecology.The Alpha and Beta diversity of each subgroup,and the differences in bacterial composition and relative abundance,were compared.Results For the AECOPD group with low-frequent of exacerbation,its diversity and abundance of microbiology were higher than those group with high-frequent of exacerbation.The group of AECOPD with respiratory failure had lower bacteria micro diversity but abundancy was higher than those group without respiratory failure.Conclusion The frequency of AECOPD and whether it is with respiratory failure is related to the change of microbiology in respiratory tract,so such change plays a great role in this disease.