标题：稳定期COPD患者下呼吸道细菌定植与血清炎症因子水平的关系

      作者：田宁强 1，苏云涛 2，陈西洲 1，刘飞 1，黄震 1    (宝鸡市中心医院综合内科 1、放疗科 2，陕西 宝鸡 721000)

      卷次： 2018年29卷15期

      【摘要】 目的 探讨稳定期慢性阻塞性肺疾病(COPD)患者下呼吸道细菌定植(LABC)与血清炎症因子水平的关系。方法 选择2016年6月至2017年4月期间宝鸡市中心医院综合内科收治的稳定期COPD患者58例为研究对象，分析患者的下呼吸道细菌定植情况，并检测血清超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α (TNF-α)、白细胞介素-6 (IL-6)水平以及肺功能指标[第一秒用力呼气量(FEV1)与用力肺活量(FVC)的比值(FEV1/FVC)，FEV1占预计值百分比(FEV1/预计值)]。结果 本组患者LABC的发生率为29.31% (17/58)，细菌检出率前三位依次为肺炎链球菌(29.41%)、流感嗜血杆菌(23.53%)和铜绿假单胞菌(17.65%)；LABC组患者吸烟指数≥400的比例为47.06%，明显高于无LABC组的17.07%，差异有统计学意义(P<0.05)；LABC组患者的血清hs-CRP、TNF-α、IL-6水平分别为(17.3±7.4) mg/L、(124.3±44.6) pg/mL、(25.5±8.2) pg/mL，明显高于无LABC组的(11.2±6.5) mg/L、(91.8±35.2) pg/mL、(18.7±7.0) pg/mL，FEV1/预计值、FEV1/FVC分别为(54.6±4.2)%、(53.9±5.4)%，均低于无 LABC组的(60.3±5.1)%、(59.3±6.8)%，差异均有统计学意义(P<0.05)。结论 部分稳定期COPD患者存在下呼吸道细菌定植，下呼吸道细菌定植可加重患者的炎症反应程度，并加重患者肺功能的损害。
      【关键词】 慢性阻塞性肺疾病；稳定期；呼吸道细菌定植；炎症因子
      【中图分类号】 R563 【文献标识码】 A 【文章编号】 1003—6350（2018）15—2125—03

Relationship between lower airway bacterial colonization and serum levels of inflammatory factors in patientswith stable chronic obstructive pulmonary disease.
TIAN Ning-qiang 1, SU Yun-tao 2, CHEN Xi-zhou 1, LIU Fei 1,HUANG Zhen 1. Department of General Medicine 1, Department of Radiotherapy 2, Baoji Central Hospital, Baoji 721000,Shaanxi, CHINA
【Abstract】 Objective To investigate the relationship between lower airway bacterial colonization (LABC)and serum levels of inflammatory factors in patients with stable chronic obstructive pulmonary disease (COPD).Methods From June 2016 to April 2017, 58 COPD patients in stable period treated in Department of General Med-icine, Baoji Central Hospital were selected as research subjects. LABC colonization in patients were analyzed, and se-rum hypersensitive C-reactive protein (hs-CRP), tumor necrosis factor alpha (TNF-α), interleukin-6 (IL-6) level and thelung function indexes (ratio of forced expiratory volume in first second and forced vital capacity [FEVl/FVC], FEVl/pre-dicted value) was tested. Results The LABC rate was 29.31% (17/58) in this study, and the detection rate was the high-est for Streptococcus pneumoniae (29.41%), followed by Haemophilus influenzae (23.53%) and Pseudomonas aeruginosa(17.65% ). The proportion of smoking index ≥400 in LABC group was 47.06% , significantly higher than 17.07% innon-LABC group (P<0.05). The serum hs-CRP, TNF-α, IL-6 in LABC group was (17.3±7.4) mg/L, (124.3±44.6) pg/mL,(25.5 ± 8.2) pg/mL, significantly higher than (11.2 ± 6.5) mg/L, (91.8 ± 35.2) pg/mL, (18.7 ± 7.0) pg/mL in non-LABCgroup. FEV1/predicted value and FEV1/FVC were (54.6±4.2)% and (53.9±5.4)%, significantly lower than (60.3±5.1)%and (59.3±6.8)% in non-LABC group (P<0.05). Conclusion Some patients with stable COPD have LABC, which canaggravate the inflammatory reaction and the impairment of lung function.
      【Key words】 Chronic obstructive pulmonary disease; Stable period; Lower airway bacterial colonization; Inflam-matory factors·论 著·doi:10.3969/j.issn.1003-6350.2018.15.016