切换至 "中华医学电子期刊资源库"

中华肺部疾病杂志(电子版) ›› 2021, Vol. 14 ›› Issue (03) : 325 -328. doi: 10.3877/cma.j.issn.1674-6902.2021.03.015

临床研究

AECOPD患者细菌和病毒感染类型及其与复发风险的相关性
于晓钧1, 孙欣2,()   
  1. 1. 543002 广西梧州市红十字会医院急诊科
    2. 543002 广西梧州市红十字会医院护理部
  • 收稿日期:2021-02-19 出版日期:2021-06-25
  • 通信作者: 孙欣

Correlation between Types of bacterial and viral infections and recurrence risk in patients with AECOPD

Xiaojun Yu1, Xin Sun2()   

  • Received:2021-02-19 Published:2021-06-25
  • Corresponding author: Xin Sun
引用本文:

于晓钧, 孙欣. AECOPD患者细菌和病毒感染类型及其与复发风险的相关性[J/OL]. 中华肺部疾病杂志(电子版), 2021, 14(03): 325-328.

Xiaojun Yu, Xin Sun. Correlation between Types of bacterial and viral infections and recurrence risk in patients with AECOPD[J/OL]. Chinese Journal of Lung Diseases(Electronic Edition), 2021, 14(03): 325-328.

目的

探讨慢性阻塞性肺疾病急性加重(AECOPD)患者细菌和病毒感染类型及其与复发风险的相关性。

方法

选择2018年8月至2019年9月于我院就诊的72例AECOPD患者为对象,所有受试者入院后均接受常规AECOPD治疗及细菌、病毒感染类型检测。治疗出院后随访1年,根据患者是否复发分为复发组和未复发组,并采用Cox回归分析AECOPD患者细菌、病毒感染类型与复发风险的相关性。

结果

72例AECOPD患者中有40.27(29/72)存在病毒感染,43.06%(31/72)的患者细菌感染。铜绿假单胞菌是最常见细菌感染类型25.81%(8/31),其次是鲍曼不动杆菌和肺炎克雷伯菌22.58%(7/31);人鼻病毒是最常见的病毒感染类型48.28%(14/29)和间质肺病毒37.93%(11/29)。随访1年后72例AECOPD患者共失访8例,最终纳入64例AECOPD患者,其中39例患者出现复发为复发组,未复发的25例患者为未复发组。单因素分析显示两组患者卡他莫拉菌、肺炎链球菌、流感嗜血杆菌、甲型流感病毒、人间质肺病毒、人鼻病毒感染比例组间比较差异有统计学意义(P<0.05)。

结论

铜绿假单胞菌、人鼻病毒是AECOPD患者最常见细菌和病毒感染类型,且人鼻病毒、肺炎链球菌、流感嗜血杆菌是AECOPD患者复发的风险因素。

表1 两组患者一般资料及细菌、病毒感染类型比较[n(%)]
表2 AECOPD患者复发的风险因子分析
1
Wang J, Chai J, Sun L, et al. The sputum microbiome associated with different sub-types of AECOPD in a Chinese cohort[J]. BMC Infect Dis, 2020, 20(1): 610.
2
Pei Z, Sun Y, Wang S, et al. Estimating mortality among in patients with acute exacerbation of chronic obstructive pulmonary disease using registry data[J]. NPJ Prim Care Respir Med, 2020, 30(1): 28.
3
Ernst P, Dahl M, Chateau D, et al. Canadian network for observational drug effect studies (CNODES) Investigators. Comparative effectiveness of fluoroquinolone antibiotic use in uncomplicated acute exacerbations of COPD: a multi-cohort study[J]. Int J Chron Obstruct Pulmon Dis, 2019, 14(1): 2939-2946.
4
Ra SW, Kwon YS, Yoon SH, et al. Sputum bacteriology and clinical response to antibiotics in moderate exacerbation of chronic obstructive pulmonary disease[J]. Clin Respir J, 2018, 12(4): 1424-1432.
5
Montón C, Prina E, Pomares X, et al. Nebulized colistin and continuous cyclic azithromycin in severe COPD patients with chronic bronchial infection due to Pseudomonas aeruginosa: a retrospective cohort study[J]. Int J Chron Obstruct Pulmon Dis, 2019, 14(1): 2365-2373.
6
慢性阻塞性肺疾病急性加重(AECOPD)诊治专家组. 慢性阻塞性肺疾病急性加重(AECOPD)诊治中国专家共识(2017年更新版)[J]. 国际呼吸杂志,2017, 37(14): 1041-1057.
7
Sperrin M, Webb DJ, Patel P, et al. Chronic obstructive pulmonary disease exacerbation episodes derived from electronic health record data validated using clinical trial data[J]. Pharmacoepidemiol Drug Saf, 2019, 28(10): 1369-1376.
8
任成山,王关嵩,钱桂生. 慢性阻塞性肺疾病的成因及其治疗的困惑与希望[J/CD]. 中华肺部疾病杂志(电子版), 2019, 12(2): 127-141.
9
Spencer L. Pulmonary rehabilitation for patients with acute chronic obstructive pulmonary disease exacerbations: is the evidence strengthening? [J]. Curr Opin Pulm Med, 2018, 24(2): 147-151.
10
Wang H, Anthony D, Selemidis S, et al. Resolving viral-induced secondary bacterial infection in COPD: a concise review[J]. Front Immunol, 2018, 9(1): 2345.
11
Ritchie AI, Wedzicha JA. Definition, causes, pathogenesis, and consequences of chronic obstructive pulmonary disease exacerbations[J]. Clin Chest Med, 2020, 41(3): 421-438.
12
Su YC, Jalalvand F, Thegerström J, et al. The interplay between immune response and bacterial infection in COPD: focus upon non-typeable Haemophilus influenzae[J]. Front Immunol, 2018, 9(1): 2530.
13
Messous S, Elargoubi A, Pillet S, et al. Bacterial and viral infection in patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease: implication for antimicrobial management and clinical outcome[J]. COPD, 2021, 18(1): 53-61.
14
Mathioudakis AG, Chatzimavridou-Grigoriadou V, Corlateanu A, et al. Procalcitonin to guide antibiotic administration in COPD exacerbations: a meta-analysis[J]. Eur Respir Rev, 2017, 26(143): 160073.
15
Stolz D, Papakonstantinou E, Grize L, et al. Time-course of upper respiratory tract viral infection and COPD exacerbation[J]. Eur Respir J, 2019, 54(4): 1900407.
16
Yin T, Zhu Z, Mei Z, et al. Analysis of viral infection and biomarkers in patients with acute exacerbation of chronic obstructive pulmonary disease[J]. Clin Respir J, 2018, 12(3): 1228-1239.
17
Alotaibi NM, Chen V, Hollander Z, et al. Phenotyping and outcomes of hospitalized COPD patients using rapid molecular diagnostics on sputum samples[J]. Int J Chron Obstruct Pulmon Dis, 2019, 14(1): 311-319.
18
Santoro A, Tomino C, Prinzi G, et al. Microbiome in chronic obstructive pulmonary disease: role of natural products against microbial pathogens[J]. Curr Med Chem, 2020, 27(18): 2931-2948.
19
Eklöf J, Sørensen R, Ingebrigtsen TS, et al. Pseudomonas aeruginosa and risk of death and exacerbations in patients with chronic obstructive pulmonary disease: an observational cohort study of 22?053 patients[J]. Clin Microbiol Infect, 2020, 26(2): 227-234.
20
Mulpuru S, Li L, Ye L, et al. Serious outcomes surveillance (SOS) network of the Canadian immunization research network (CIRN). Effectiveness of influenza vaccination on hospitalizations and risk factors for severe outcomes in hospitalized patients with COPD[J]. Chest, 2019, 155(1): 69-78.
21
Menzel M, Ramu S, Calvén J, et al. Oxidative stress attenuates TLR3 responsiveness and impairs anti-viral mechanisms in bronchial rpithelial cells from COPD and asthma patients[J]. Front Immunol, 2019, 10(1): 2765.
22
Choi J, Oh JY, Lee YS, et al. Bacterial and viral identification rate in acute exacerbation of chronic obstructive pulmonary disease in Korea[J]. Yonsei Med J, 2019, 60(2): 216-222.
23
Choi J, Oh JY, Lee YS, et al. Pseudomonas aeruginosa infection increases the readmission rate of COPD patients[J]. Int J Chron Obstruct Pulmon Dis, 2018, 13(1): 3077-3083.
24
Jafarinejad H, Moghoofei M, Mostafaei S, et al. Worldwide prevalence of viral infection in AECOPD patients: A meta-analysis[J]. Microb Pathog, 2017, 113(1): 190-196.
25
Niespodziana K, Napora K, Cabauatan C, et al. Misdirected antibody responses against an N-terminal epitope on human rhinovirus VP1 as explanation for recurrent RV infections[J]. FASEB J, 2012, 26(3): 1001-1008.
26
Chen Y, Kumar RK, Thomas PS, et al. Th1/17-Biased inflammatory environment associated with COPD alters the response of airway epithelial cells to viral and bacterial stimuli[J]. Mediators Inflamm, 2019, 20(19): 7281462.
[1] 农云洁, 黄小桂, 黄裕兰, 农恒荣. 超声在多重肺部感染诊断中的临床应用价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(09): 872-876.
[2] 许月芳, 刘旺, 曾妙甜, 郭宇姝. 多粘菌素B和多粘菌素E治疗外科多重耐药菌感染临床疗效及安全性分析[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 700-703.
[3] 梁孟杰, 朱欢欢, 王行舟, 江航, 艾世超, 孙锋, 宋鹏, 王萌, 刘颂, 夏雪峰, 杜峻峰, 傅双, 陆晓峰, 沈晓菲, 管文贤. 联合免疫治疗的胃癌转化治疗患者预后及术后并发症分析[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 619-623.
[4] 王功炜, 李书豪, 魏松, 吕博然, 胡成. 溶瘤病毒M1对不同前列腺癌细胞杀伤效果的研究[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(06): 626-632.
[5] 皮尔地瓦斯·麦麦提玉素甫, 李慧灵, 艾克拜尔·艾力, 李赞林, 王志, 克力木·阿不都热依木. 生物补片修补巨大复发性腹壁切口疝临床疗效分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 624-628.
[6] 顾熙, 徐子宇, 周澍, 张吴楼, 张业鹏, 林昊, 刘宗航, 嵇振岭, 郑立锋. 腹股沟疝腹膜前间隙无张力修补术后补片感染10 例报道[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 665-669.
[7] 臧宇, 姚胜, 朱新勇, 戎世捧, 田智超. 低温等离子射频消融治疗腹壁疝术后补片感染的临床效果[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 687-692.
[8] 杨闯, 马雪. 腹壁疝术后感染的危险因素分析[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 693-696.
[9] 中华医学会器官移植学分会. 肝移植术后缺血性胆道病变诊断与治疗中国实践指南[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 739-748.
[10] 刘敏思, 李荣, 李媚. 基于GGT与Plt比值的模型在HBV相关肝细胞癌诊断中的作用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 831-835.
[11] 张润锦, 阳盼, 林燕斯, 刘尊龙, 刘建平, 金小岩. EB病毒相关胆管癌伴多发转移一例及国内文献复习[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 865-869.
[12] 董佳, 王坤, 张莉. 预后营养指数结合免疫球蛋白、血糖及甲胎蛋白对HBV 相关慢加急性肝衰竭患者治疗后预后不良的预测价值[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 555-559.
[13] 贾玲玲, 滕飞, 常键, 黄福, 刘剑萍. 心肺康复在各种疾病中应用的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 859-862.
[14] 颜世锐, 熊辉. 感染性心内膜炎合并急性肾损伤患者的危险因素探索及死亡风险预测[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 618-624.
[15] 闫维, 张二明, 张克, 安欣华, 向平超. 北京市石景山区40岁及以上居民早期慢性阻塞性肺疾病异质性及影响因素分析[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 533-540.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?