稳定期慢性阻塞性肺疾病下呼吸道细菌定植与气道炎症关系的研究

目的:研究稳定期慢性阻塞性肺疾病(COPD)患者下呼吸道细菌定植与气道炎症、吸烟、肺功能的关系。方法:入选34例稳定期COPD门诊患者,测定其肺功能,留取深部痰液进行细菌定量培养。抽取静脉血,检测血清和痰液白细胞介素-8(IL-8)浓度,对他们的相关性进行统计学分析。结果:下呼吸道细菌定植≥107菌落形成单位(CFU)/mL组,其血清及痰液IL-8浓度与下呼吸道细菌定植量<107CFU/mL组相比,2组差异有显著性(P<0.05)。下呼吸道细菌定植≥107CFU/mL组吸烟指数与下呼吸道细菌定植量<107CFU/mL组相比,2组差异有显著性(P<0.05)。第一秒用力呼气量(FEV1)<50%预计值组细菌定植量与FEV1≥50%预计值组比较,2组差异有显著性(P<0.05)。结论:稳定期COPD患者的气道炎症与吸烟和下呼吸道细菌定植有关,吸烟和下呼吸道细菌定植可导致气道炎症加重。

Association between lower airway bacterial colonization and airway inflammation in patients with stable chronic obstructive pulmonary disease

Objective:The aim of this prospective study was to investigate association among airway inflammation, lower airway bacterial colonization(LABC), smoking and pulmonary function in pationts with chronic obstructive pulmonary disease(COPD).Method:34 patients with stable COPD were studied.Induced sputum and serum samples were obtained from all of the patients for quantitative sputum cultares and determination of interleukin_8 in sputum and serum.Result:1.There were 11 patients with LABC≥10~7colony-forming unit/mL and 23 patients with LABC <10~7 colony_forming unit/mL.The concentration of interleukin_8 of the patients with LABC ≥10~7 colony-forming unit/mL was (71.18±20.11 )pg/mL in serum,and (374.75±82.34)pg/mL in sputum.The concentration of IL-8 of the patients with LABC<10~7 colony-forming unit/mL was (13.98±2.97)pg/mL in serum,and (144.42±26.25)pg/mL in sputum.The concentration of interleukin-8 was correlated with LABC( P <0.05). Pack years of the patients with LABC≥10~7 colony-forming unit/mL was 36.45±7.42,but pack years of the patients with LABC<10~7 colony-forming unit/mL was 14.18±6.78. LABC was correlated with pack years ( P <0.05).2.There were 17 patients with forced expiratory volume (FEV1)<50% of predicted whose LABC was 7.11±0.17. There were 17 patients whose FEV1≥50% of predicted and whose LABC was 5.60±0.54.The quantitative of lower airway bacterial colonization correlated with lung function( P <0.05).Conclusion:Some of the stable COPD patients have LABC.The quantitative of LABC and smoking were correlated with airway inflammation. LABC and smoking and airway inflammation have effects on the patients, which cause the lung function of stable COPD patients to decrease continuously.