标题：稳定期老年COPD患者下呼吸道细菌定植与肺功能的相关性

      作者：孟鸿琼，龙琼华，苏慧鹏，金醒昉，邓洁，胡阳    (昆明医科大学附属延安医院老年病科，云南 昆明 650031)

      卷次： 2018年29卷20期

      【摘要】 目的 研究稳定期老年慢性阻塞性肺疾病(COPD)患者不同程度肺功能下呼吸道细菌定植(LABC)情况，并探讨其相关性。方法 纳入 2014年 1月至 2015年 12月昆明医科大学附属延安医院老年病科慢病管理人群中诊断明确的老年(≥65岁)稳定期COPD患者 86例，对其诱导痰液或支气管肺泡灌洗液(BALF)进行细菌学定量，根据患者LABC情况分为LABC阳性者与LABC阴性者，应用酶联免疫吸附法(ELISA)检测患者血清白介素 6 (IL-6)、白介素 8 (IL-8)、超敏C反应蛋白(hs-CRP)及肿瘤坏死因子-α (TNF-α)水平，同时测定肺活量(FVC)、第一秒用力呼气容积(FEV1)、FEV1%预计值(FEV1%pred)、FEV1/FVC。比较两组患者的肺功能及炎性因子水平。结果 86例COPD患者中有39例存在下呼吸道细菌定植，细菌定植率为45.35%；LABC阳性组患者的FEV1%pred、FEV1/FVC水平及急性发作次数分别为(35.35±8.21)%、(45.53±16.33)%、(1.45±0.55)次，LABC阴性组则分别为(48.15±6.23)%、(60.33±11.75)%、(1.175±0.25)次，两组比较差异均有统计学意义(P<0.05)；FEV1<50%pre LABC阳性患者血清TNF-α、IL-6、IL-8、hs-CRP水平分别为(173.4±15.7) μg/L、(182.3±14.4) ng/L、(58.3±46.4) ng/L、(11.7±9.5) mg/L，FEV1≥50%pre LABC阳性患者的上述各项炎性因子水平分别为(136.3±18.1) μg/L、(125.7±17.5) ng/L、(47.9±21.5) ng/L、(10.8±7.5) mg/L，两组比较差异均有统计学意义(P<0.05)。结论 LABC与肺功能的损害程度及COPD的加重有关，可能是影响COPD患者病情恶化的危险因素。
      【关键词】 老年；稳定期老年慢性阻塞性肺疾病；下呼吸道细菌定植；炎性因子；肺功能
      【中图分类号】 R563 【文献标识码】 A 【文章编号】 1003—6350（2018）20—2836—04

Correlation between lower airway bacterial colonization and lung function in elderly patients with stable chronicobstructive pulmonary disease.
MENG Hong-qiong, LONG Qiong-hua, SU Hui-peng, JIN Xing-fang, DENG Jie, HUYang. Department of Geriatrics, Yan'an Affiliated Hospital of Kunming Medical University, Kunming 650031, Yunnan,CHINA
【Abstract】 Objective To study the lower airway bacterial colonization (LABC) in elderly patients with stablechronic obstructive pulmonary disease (COPD) in different degrees of lung function and to explore their correlation.Methods A total of 86 patients with stable COPD in the elderly (≥65 years old) were selected, who were diagnosed inthe Department of Geriatrics at the Yan'an Affiliated Hospital of Kunming Medical University from January 2014 to De-cember 2015. The bacteriological quantification of induced sputum or bronchoalveolar lavage fluid (BALF) from the pa-tients were performed. According to the results of LABC, these patients were divided into LABC-positive group andLABC-negative group. Then serum level of interleukin 6 (IL-6), interleukin 8 (IL-8), hypersensitive C-reactive protein(hs-CRP) and tumor necrosis factor-α (TNF-α) were detected by enzyme-linked immunosorbent assay (ELISA), andforced vital capacity (FVC), forced expiratory volume in first second (FEV1), FEV1% predicted value (FEV1%pred), andFEV1/FVC ratio were measured simultaneously. Pulmonary function and the levels of inflammatory factors were com-·论 著·doi:10.3969/j.issn.1003-6350.2018.20.008基金项目：云南省教育厅科学研究基金项目(编号：2014Y164)；云南省昆明市卫生和计划生育委员会医药卫生科技计划项目(编号:2018-03-02-009)