慢阻肺患者下呼吸道微生物定植与肺部感染炎症指标的关系

Relationship between Microbial Colonization of the Lower Respiratory Tract and Inflammatory Markers of Lung Infection in COPD Patients

目的探究慢性阻塞性肺疾病(以下简称“慢阻肺”)患者下呼吸道微生物定植与肺部感染炎症指标的关系。方法选取2021年5月至2023年4月平顶山河舞总医院检验科收治的189例慢阻肺患者作为研究对象。根据是否发生肺部感染,将患者分为感染组和非感染组;根据是否存在呼吸道微生物定植分组,将患者分为定植组和非定植组,比较各组血清指标降钙素原(Procalcitonin,PCT)、超敏C-反应蛋白(Hypersensitivity C-Reactive Protein,hs-CRP)、白细胞介素-8(Interleukin-8,IL-8)、肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)水平,并通过Spearman分析慢阻肺患者下呼吸道微生物定植与肺部感染炎症指标的相关性。结果在189例患者中,肺部感染者占62.96%(119/189),检出病原菌233株,其中革兰阴性菌占72.53%(169/233),革兰阳性菌占17.59%(41/233),真菌占9.87%(23/233);下呼吸道微生物定植占29.10%(55/189)。感染组下呼吸道微生物定植发生率、PCT、hs-CRP、IL-8及TNF-α水平均高于非感染组(P<0.05)。定植组PCT、hs-CRP、IL-8及TNF-α水平均高于非定植组(P<0.05)。慢阻肺患者肺部感染与下呼吸道微生物定植、PCT、hs-CRP、IL-8及TNF-α呈正相关(P<0.05)。结论慢阻肺患者下呼吸道微生物定植菌株以革兰阴性菌为主,且与肺部感染关系密切,其可能通过加重炎症反应而增加肺部感染发生率。

Objective To investigate the relationship between microbial colonization of the lower respiratory tract and inflammatory indexes of lung infection in patients with chronic obstructive pulmonary disease(COPD).Methods 189 patients with COPD in the Department of Laboratory of Pingdingshan Hewu General Hospital from May 2021 to April 2023 were selected as research objects.According to the occurrence of lung infection,they divided into infected group and non-infected group.According to the presence or absence of respiratory microbial colonization group,they were divided into colonization group and non-colonization group,and the serum indexes of procalcitonin(PCT),hypersensitivity C-reactive protein(hs-CRP),interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)levels were compared between each group,and the correlation between lower respiratory tract microbial colonization and inflammatory markers of lung infection in patients with COPD was analyzed by Spearman.Results Among the 189 patients,the infected accounted for 62.96%(119/189)and 233 strains of pathogenic bacteria were detected,including 72.53%(169/233)of gram-negative bacteria,17.59%(41/233)of gram-positive bacteria and 9.87%(23/233)of fungi.Microbial colonization of the lower respiratory tract accounted for 29.10%(55/189).The incidence of lower respiratory tract colonization,PCT,hs-CRP,IL-8 and TNF-αlevels in the infected group were higher than those in the non-infected group(P<0.05).The levels of PCT,HS-CRP,IL-8 and TNF-αin the colonized group were higher than those in the non-colonized group(P<0.05).Pulmonary infection in COPD patients was positively correlated with lower respiratory tract microbial colonization,PCT,HS-CRP,IL-8 and TNF-α(P<0.05).Conclusion The microbial colonization strains of the lower respiratory tract of COPD patients are mainly gram-negative bacteria and are closely related to lung infection,which may increase the incidence of lung infection by aggravating the inflammatory response.