标题：AECOPD合并呼吸道病毒感染的病原体分布、血清炎症因子水平变化及临床意义

      作者：王学锷，朱运奎，李超然，马宣，黄金田    西北大学附属西安国际医学中心医院呼吸与危重医学科，陕西 西安 710100

      卷次： 2023年34卷5期

      【摘要】 目的 研究慢性阻塞性肺疾病急性加重期(AECOPD)合并呼吸道病毒感染的病原体分布、血清炎症因子水平变化及临床意义。方法 选取2018年1月至2021年12月期间西北大学附属西安国际医学中心医院呼吸与危重医学科收治的96例AECOPD患者作为研究对象。经临床聚合酶链式反应(PCR)检测患者病毒的感染情况，将50例合并有呼吸道病毒感染者作为研究组，46例未合并呼吸道病毒感染者作为对照组。患者入院后第 2天检测，记录并比较两组患者血清中炎症因子[白细胞介素-6 (IL-6)、白细胞介素-8 (IL-8)、肿瘤坏死因子α (TNF-α)、C反应蛋白(CRP)]水平、肺功能指标[第1秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)]水平，并采用Pearson相关性分析法分析患者的炎症因子与肺功能指标的相关性。结果 96例AECOPD患者中共检出呼吸道病毒感染者为50例，其中主要以甲型流感病毒、乙型流感病毒、鼻病毒为主；研究组患者血清中 IL-6、IL-8、TNF-α、CRP水平分别为(28.52±3.52) ng/L、(29.28±4.06) ng/L、(37.48±8.46) ng/L、(16.52±2.57) mg/L，明显高于对照组的(20.48±3.27) ng/L、(21.06±4.18) ng/L、(29.46±7.52) ng/L、(11.58±3.14) mg/L，差异均有统计学意义(P<0.05)；研究组患者的FEV1、FEV1/FVC水平分别为(1.12±0.38) L、(42.56±6.38)%，明显低于对照组的(2.48±0.46) L、(64.68±5.27)%，差异均有统计学意义(P<0.05)；经Pearson相关性分析结果显示，患者血清 IL-6、IL-8、TNF-α、CRP水平与FEV1、FEV1/FVC水平均呈负相关(P<0.05)。结论 AECOPD合并呼吸道病毒感染患者的病原体分布主要以甲型流感病毒、乙型流感病毒、鼻病毒为主，通过监测患者的炎症因子能及时了解患者的病情及肺功能情况，具有临床应用价值。
      【关键词】 慢性阻塞性肺疾病急性加重期；呼吸道病毒感染；病原体分布；炎症因子；肺功能
      【中图分类号】 R563 【文献标识码】 A 【文章编号】 1003—6350（2023）05—0676—04

Distribution of pathogens, changes of serum inflammatory factors and their clinical significance in patients withAECOPD complicated with respiratory virus infection.
WANG Xue-e, ZHU Yun-kui, LI Chao-ran, MA Xuan, HUANGJin-tian. Department of Respiratory and Critical Care Medicine, Xi'an International Medical Center Hospital Affiliated toNorthwest University, Xi'an 710100, Shaanxi, CHINA
【Abstract】 Objective To study the distribution of pathogens, changes of serum inflammatory factors and theirclinical significance in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicat-ed with respiratory virus infection. Methods From January 2018 to December 2021, 96 patients with AECOPD whowere admitted to the Department of Respiratory and Critical Care Medicine, Xi'an International Medical Center HospitalAffiliated to Northwest University were selected as the study subjects. The virus infection of patients was detected byclinical polymerase chain reaction (PCR). Fifty patients with respiratory virus infection were taken as the study group,and 46 patients without respiratory virus infection were taken as the control group. The levels of serum inflammatory fac-tors [interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor α (TNF-α), C-reactive protein (CRP)] and pulmo-nary function indexes [forced expiratory volume in the first second (FEV1), FEV1/forced pulmonary activity (FVC)]were detected, recorded and compared between the two groups. Pearson correlation analysis was used to analyze the cor-relation between inflammatory factors and lung function indicators. Results A total of 50 cases of respiratory virus in-fections were detected in 96 AECOPD patients, among which influenza A virus, influenza B virus, and rhinovirus werethe main viruses. IL-6, IL-8, TNF-α, CRP levels in serum of patients in the study group were (28.52±3.52) ng/L,(29.28±4.06) ng/L, (37.48±8.46) ng/L, and (16.52±2.57) mg/L, which were significantly higher than (20.48±3.27) ng/L,(21.06±4.18) ng/L, (29.46±7.52) ng/L, and (11.58±3.14) mg/L in the control group (P<0.05). The levels of FEV1 andFEV1/FVC in the study group were (1.12±0.38) L and (42.56±6.38)%, which were significantly lower than (2.48±0.46) Land (64.68±5.27)% in the control group (P<0.05). Pearson correlation analysis showed that the patient's serum IL-6,IL-8, TNF-α, CRP levels were negatively correlated with FEV1 and FEV1/FVC levels (P<0.05). Conclusion The patho-gens of patients with AECOPD complicated by respiratory virus infection are mainly influenza A virus, influenza B vi-rus, and rhinovirus. Monitoring the inflammatory factors of patients can timely understand the patient's condition andpulmonary function, which has high clinical application value.
      【Key words】 Acute exacerbation of chronic obstructive pulmonary disease; Respiratory virus infection; Pathogendistribution; Inflammatory factors; Pulmonary function