摘要
目的探讨慢性阻塞性肺疾病急性加重(AECOPD)患者病毒感染的相关因素,为进一步改善COPD患者病情,提供针对性治疗方案。方法选取2014年5月-2015年5月医院就诊AECOPD患者175例,采用鼻拭子获取分泌物及鼻黏膜细胞,使用15联呼吸道病毒荧光标记PCR检测试剂盒进行检测,并使用临床登记观察表记录患者临床相关信息,分析AECOPD患者病毒感染的相关因素,使用频数分析、logistic回归进行统计分析。结果 175例AECOPD患者病毒检测阳性68例,阳性率为38.86%;检出病毒70株,其中排前5位的病毒为呼吸道合胞病毒B型(16株,22.86%),鼻病毒A/B/C(10株,14.29%)、偏肺病毒(9株,12.86%)、人博卡病毒1/2/3/4(7株,10.00%)、冠状病毒OC43(7株,10.00%);病毒检测阳性与阴性患者相比,体质量指数差异有统计学意义(P<0.05);logistic单因素分析及多因素分析结果显示,糖尿病、吸烟、呼吸衰竭、上1年加重次数、体质量指数下降是COPD急性加重期患者病毒感染的重要危险因素(P<0.05)。结论病毒感染是导致AECOPD患者的常见原因之一,糖尿病、吸烟、呼吸衰竭、体质量指数下降、上1年急性加重次数增多是呼吸道病毒感染的危险因素,控制体重、吸烟、降低血糖等对预防AECOPD患者病毒感染具有一定的临床意义。
OBJECTIVE To explore the factors related to viral infection in patients with acute exacerbation of chronic obstructive pulmonary disease,so as to provide targeted treatment programs to further improve the condition of patients with COPD.METHODS A total of 175 patients of with acute exacerbation of COPD from May 2014 to May 2015 were recruited from the inpatient department of the hospital.Nasal swabs were used to obtain secretions and nasal mucosal cells.The detection kit was used to detect 15 cases of respiratory tract virus by fluorescence labeling PCR.Clinically relevant information were recorded by using a clinical registration.Frequency analysis and logistic regression were used for statistical analysis.RESULTS The detection rate of virus infection in acute exacerbation of chronic obstructive pulmonary disease（COPD）was 38.86%.The most frequently detected viruses included 16 strains of respiratory syncytial virus（22.86%）,10 strains of rhinovirus（14.29%）,9strains of metapneumovirus（12.86%）,7strains of human Boca virus（10.00%）,7strains of coronavirus OC43（10.00%）.There was a significant difference in BMI index between positive-virus patients and negative-virus patients（P〈0.05）.Univariate and multivariate of logistic analysis showed that diabetes,smoking,respiratory failure,increased times of deterioration previous year,and decreased BMI index were risk factors for virus infection with chronic obstructive pulmonary disease（COPD）acute exacerbation（P0.05）.CONCLUSIONViral infection is one of the common causes of acute exacerbation in COPD patients.The diabetes,smoking,respiratory failure,decreased BMI index and increased times of deterioration previous year are risk factors of virus infection of acute exacerbations of COPD patients.It has a certain clinical significance to prevent COPD patients with acute exacerbation of viral infection by controlling weight,avoiding smoking,and reducing blood sugar.
作者
龚峰
张晓调
陈显静
张鸣华
上官宗校
GONG Feng ZHANG Xiao diao CHEN Xian-jing ZHANG Ming-hua SHANGGUAN Zong-xiao(Ruian City People＇s Hospital, Ruian, Zhejiang 325200, Chin)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第4期800-803,共4页
Chinese Journal of Nosocomiology
基金
浙江省医药卫生一般研究计划基金资助项目(2013KYA223)52~1165
