标题：榆林地区气象因素与慢性阻塞性肺疾病急性加重的关系

      作者：张启龙 1，蓸茸 1，高隆 1，王志飞 1，邓宝娟 1，石志红 2    1.榆林市第一医院全科医学科，陕西 榆林 719000；2.西安交通大学第一附属医院呼吸与危重症医学科，陕西 西安 710065

      卷次： 2023年34卷23期

      【摘要】 目的 探究榆林地区气象因素与慢性阻塞性肺疾病(COPD)急性加重的关系。方法 回顾性分析2019年1月至2020年1月经榆林市第一医院治疗的200例COPD急性加重患者的临床资料以及入院期间榆林地区的气象情况(日平均气温、日平均气压、日平均相对湿度、日平均温极差、日平均日照时间、日平均风速)。分析患者的菌群分布及不同季节COPD急性加重患者的病菌检出情况；采用Spearman相关分析法分析气象因素与COPD急性加重的相关性。结果 革兰阴性细菌的株数分布率为53.00%，革兰阳性细菌株数分布率为19.00%，真菌株数分布率为28.00%；春季COPD急性加重患者的细菌阳性率、革兰阴性感染率明显高于夏季、秋季和冬季的患者，差异具有统计学意义(P<0.05)，而四季的革兰阳性细菌感染率及真菌感染率比较差异无统计学意义(P>0.05)；榆林地区COPD急性加重入院率与日平均气温、日平均湿度、日平均日照时间呈负相关(r=-0.467、-0.326、-0.374，P<0.05)，痰细菌培养阳性检出率与日平均气温、日平均湿度呈负相关(r=-0.635、-0.552，P<0.05)；呼吸衰竭发生率与日平均气压、日平均温极差呈正相关(r=0.216、0.564，P<0.05)，与日平均气温、日平均日照时间呈负相关(r=-0.519、-0.362，P<0.05)；COPD患者的急性加重入院率、痰细菌培养阳性检出率及呼吸衰竭发生率与日平均风速无相关性(r=-0.409、-0.196、-0.121，P>0.05)。结论 COPD急性加重与该地区气象因素密切相关，其中以日平均气温、日平均湿度、日平均气压、日平均日照时间最为显著。急性加重时病原菌检出阳性率最高的季节为春季，以革兰阴性细菌为主。
      【关键词】 慢性阻塞性肺疾病急性加重；气象因素；呼吸道病原菌；季节性；相关性
      【中图分类号】 R563 【文献标识码】 A 【文章编号】 1003—6350（2023）23—3396—05

Relationship between meteorological factors and acute attack of chronic obstructive pulmonary disease in Yulin.ZHANG Qi-long 1, LI Rong 1, GAO Long 1, WANG Zhi-fei 1, DENG Bao-juan 1, SHI Zhi-hong 2.
1. Department of GeneralMedicine, Yulin First Hospital, Yulin 719000, Shaanxi, CHINA; 2. Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710065, Shaanxi, CHINA
【Abstract】 Objective To explore the relationship between meteorological factors and acute exacerbation ofchronic obstructive pulmonary disease (COPD) in Yulin region. Methods A retrospective analysis was conducted onthe clinical data of 200 patients with acute exacerbation of COPD treated at the First Hospital of Yulin from Janu-ary 2019 to January 2020, along with the meteorological conditions in Yulin during their hospitalization (daily aver-age temperature, daily average atmospheric pressure, daily average relative humidity, daily average temperature dif-ference, daily average sunshine duration, daily average wind speed). The distribution of bacterial communities inpatients and the detection of bacteria in patients with acute exacerbation of COPD in different seasons were ana-lyzed. Spearman correlation analysis was used to analyze the correlation between meteorological factors and acuteexacerbation of COPD. Results The distribution rate of Gram-negative bacteria, Gram-positive bacteria, fungiwas 53.00%,19.00%, 28.00%, respectively. The bacterial positive rate and Gram-negative infection rate of patientswith acute exacerbation of COPD in spring were significantly higher than those in summer, autumn, and winter (P<0.05). There was no statistically significant difference in the infection rates of Gram-positive bacteria and fungi amongthe four seasons (P>0.05). The admission rate of acute exacerbation of COPD in Yulin area is negatively correlated withdaily average temperature, daily average humidity, and daily average sunshine time (r=-0.467, -0.326, -0.374, P<0.05),while the positive detection rate of sputum bacterial culture was negatively correlated with daily average temperatureand daily average humidity (r=-0.635, -0.552, P<0.05). The incidence of respiratory failure was positively correlatedwith daily average air pressure and temperature range (r=0.216, 0.564, P<0.05), and negatively correlated with daily av-erage air temperature and daily average sunshine time (r=-0.519, -0.362, P<0.05). The acute exacerbation admission rate,positive sputum bacterial culture detection rate, and incidence of respiratory failure in COPD patients were not correlatedwith daily average wind speed (r=-0.409, -0.196, -0.121, P>0.05). Conclusion The acute exacerbation of COPD isclosely related to meteorological factors in the region, with daily average temperature, daily average humidity, daily aver-age pressure, and daily average light duration being the most significant. The season with the highest positive rate of patho-genic bacteria detection during acute exacerbation is spring, with Gram-negative bacteria being the main cause.
      【Key words】 Acute exacerbation of chronic obstructive pulmonary disease; Meteorological factors; Respiratorypathogenic bacteria; Seasonality; Relationship