稳定期慢性阻塞性肺疾病患者呼吸道细菌定植与炎性细胞关系的研究

目的探讨稳定期慢性阻塞性肺疾病(COPD)患者呼吸道细菌定植与炎性细胞的关系。方法选择稳定期COPD患者100例,收集痰液标本,测定痰液内IL-8、IL-6及TNF-α水平,检测患者肺功能。观察稳定期COPD患者下呼吸道细菌定植情况。比较细菌数量≥10~7 CFU/ml者及<10~7 CFU/ml者痰液细胞因子测定结果,分析患者肺功能与下呼吸道细菌定植的关系。结果呼吸道定植菌以流感嗜血杆菌最多,其次为肺炎链球菌。细菌数量≥10~7CFU/ml者,IL-8、IL-6及TNF-α水平均显著高于细菌数量<10~7 CFU/ml者(P<0.05)。随访1年,细菌数量≥10~7CFU/ml者,FEV_1下降值及FEV_1预计值变化显著高于细菌数量<10~7 CFU/ml者,急性加重次数显著多于细菌数量<10~7 CFU/ml者(P<0.05)。FEV_1<50%预计值患者下呼吸道细菌定植数量显著高于FEV_1≥50%预计值者(P<0.05)。结论下呼吸道细菌定植可以加重稳定期COPD患者气道炎性反应,随定植细菌数量增多,患者发生急性加重次数增加,肺功能降低明显。

Study on the relationship between respiratory tract bacterial colonization and inflammatory cells in patients with stable chronic obstructive pulmonary disease

Objective To investigate the relationship between respiratory tract bacterial colonization and inflammatory cells in patients with stable COPD.Methods 100 patients with stable COPD were chosen,sputum IL-8,IL-6 and TNF-αwere measured,lung function were detected.Lower respiratory tract colonization of patients was observed.Sputum cytokine of bacterial counts≥10~7 CFU/ml and10~7 CFU/ml patients were compared.The relationship between lung function and lower respiratory tract bacterial colonization were observed.Results Haemophilus influenza accounted for the most counts,followed by streptococcus pneumonia.In patients whose number of bacteria≥10~7 CFU/ml,IL-8,IL-6 and TNF-αwere significantly higher than those10~7CFU/ml（P0.05）.After 1 year follow up,patients whose number of bacteria≥10~7CFU/ml,FEV_1 decline,FEV_1 pre changes and the numbers of acute exacerbation were significandy larger than those10~7CFU/ml（P0.05）.The number of lower respiratory tract bacterial colonization in patients whose FEV_150%significantly greater than those whose FEV_1≥50%（P0.05）.Conclusion Airway bacterial colonization can aggravate stable the chronic obstructive pulmonary disease in patients with airway inflammation,with the colonization of bacteria increased in the number,patients＇ lung function decreased significantly.