呼吸道合胞病毒感染对AECOPD患者气道炎性损伤及血清SAA和CRP水平的影响

Effects of respiratory syncytial virus infection on airway inflammatory injury,serum SAA and CRP levels in AECOPD patients

目的分析慢性阻塞性肺疾病急性加重期(AECOPD)患者合并呼吸道合胞病毒(RSV)感染危险因素,并探讨RSV感染对气道炎性损伤及血清淀粉样蛋白A(SAA)和C-反应蛋白(CRP)水平的影响。方法选取2020年6月一2023年6月温州市中西医结合医院确诊的50例AECOPD合并RSV感染患者为感染组,另根据倾向性匹配原则等比纳入50例单纯AECOPD患者为未感染组,检测两组患者痰液中中性粒细胞(Neu)、淋巴细胞(Lym)、巨噬细胞(Macro)及嗜酸性细胞(Eos)数目以及血清SAA、CRP水平,并分析气道炎性损伤与血清指标的关系。结果Logistic回归分析结果,吸烟、呼吸衰竭、1年内加重次数均为影响AECOPD患者发生RSV感染的危险因素(OR=3.337、4.354、4.229P<0.05);相较于未感染组,感染组痰液Neu、Lym、Macro、EOS细胞计数以及血清SAA、CRP水平较高(P<0.05);Pearson相关性分析结果显示,感染组患者血清SAA、CRP水平与痰液Neu、Lym、Macro、EOS均呈正相关(均P<0.001)。结论RSV感染可能会促进AECOPD患者气道炎症损伤加重,其血清SAA、CRP水平升高。

OBJECTIVE To analyze the risk factors of respiratory syncytial virus(RSV)infection in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),and to explore the effects of RSV infection on airway inflammatory injury and serum levels of amyloid A(SAA)and C-reactive protein(CRP).METHODS A total of 50 patients with AECOPD infected with RSV and 50 patients with simple AECOPD in the Hospital of Integrated Traditional Chinese and Western Medicine of Wenzhou between Jun 2020 and Jun 2023 were enrolled as the infection group and non-infection group,respectively.The counts of neutrophils(Neu),lymphocytes(Lym),macrophages(Macro)and eosinophils(Eos)in sputum,serum levels of SAA and CRP in the two groups were detected.The relationship between airway inflammatory injury and serum indexes was analyzed.RESULTS The results of multivariate logistic regression analysis showed that smoking,respiratory failure and aggravation frequency within one year were risk factors for RSV infection in AECOPD patients(OR=3.337,4.354,4.229,P<0.05).Compared with the non-infection group,counts of sputum Neu,Lym,Macro and EOS,and serum levels of SAA and CRP were higher in the infection group(P<o.05).Pearson correlation analysis showed that serum SAA and CRP levels were positively correlated with sputum Neu,Lym,Macro and EOS in the infection group(all P<0.001).CONCLUSION RSV infection may aggravate airway inflammatory injury and significantly increase levels of serum SAA and CRP in AECOPD patients.