慢性阻塞性肺疾病急性加重期痰细菌培养与肺功能关系探讨

An investigation on the interrelation of bacteriologic etiology and pulmonary fu nction in the period of infective exacerbation of patients with chr onic obstructive pulmonary

目的 探讨慢性阻塞性肺疾病 (COPD)急性加重期患者的痰细菌学特征以及细菌感染与肺功能损伤的关系。 方法 对在我院就诊痰培养阳性的 77例急性期COPD患者进行肺功能测试 ,并根据肺功能测试结果将患者分为三个期。 结果 77例痰菌培养阳性患者根据细菌培养结果分为 5组 ,A组为G+ 球菌 ,B组为除C组以外的G 杆菌 ,C组为肠杆菌和假单孢菌 ,D组为霉菌 ,E组为D组合并前A或C组中任何一类。Ⅰ期 (FEV1 ≥ 5 0 %预计值 ) 2 0例中 10例为A组 ,4例为B组 ,6例为C组 ;Ⅱ期 (30 % <FEV1 <5 0 %预计值 ) 2 4例 6例A为组 ,8例为B组 ,8例为C组 ,1例为D组 ,1例为E组 ;Ⅲ期 (FEV1 ≤ 30 %预计值 ) 33例中 2例为A组 ,9例为B组 ,18例为C组 ,1例为D组 ,3例为E组。 结论 这 5组细菌导致感染加重不是平均分配在三个不同程度肺功能损害的阶段 ,对严重感染的患者来讲 ,肺功能损害和细菌是相互联系的 ,肠杆菌和假单胞菌是FEV1 ≤ 30 %COPD预计值急性感染加重期患者的优势菌。

Objective To investigate the interrelation between decrease of pulmonary function and the sputum culture in the persiod of acute exacerbation in elderly patients with CO PD. Methods The pulmonary function was tested in the persiod of a cute infective exacerbartion in 77 patsents with COPD and their sputum culture w as positive result,the results conducted a controlled analysis. Result s The results of pulmonary function test were stageⅠ(the predictad value of FEV_1≥50%) in 20 patients,stageⅡ(>30% to <50%) 22 patie n ts,stageⅢ(≤30%) 34 patients.Sputum culture according to the different bacte ri a was divided into five groups:group A was part of Gram-positive cocei,group B Gram-negativ e except group C,group C Enterobactericeae and pseudomonas spp,group D Fungus,gr oup E included the bacteria which grew and reproduced in group D and one of A or C.In stage Ⅰ 10 cases were group A,4 cases group B ,and 6 cases group C.In stage Ⅱ 6 cases group A,8 cases group B,8 cases group C,1 case group D,and 1 case group E.In stage Ⅲ 2 cases group A,9 cases grou p B,18 cases group C,1 case group D,and 3 cases group E. Conclusion Our findings provide evidence that diffarent bacte sia could cause the change of pulmonary function in patients with CORD,specialh y t he Enterobactericeae and Pseudomonas spp lead to grave damage for pulmonary fun ction(FEV_1<30%).