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目的:探讨呼吸道病毒与慢性阻塞性肺疾病急性加重(AECOPD)的相关性,以期能为AECOPD的诊治提供参考。方法:选取200例AECOPD患者为研究对象,检测患者肺功能,用Luminex xMAP多重分析技术平台,采集患者咽试子建立多重PCR检测技术,对鼻病毒(RHV)、呼吸道合胞病毒(RSV)、流感病毒A(INF-A)、流感病毒B(INF-B)、副流感病毒(PIV)、腺病毒(ADV)进行检测。结果:200例患者肺功能分级I级25例,II级62例,III级96例,IV级17例,其构成比分别为17.50%、31.00%、48.00%、8.50%;咽试子共检出呼吸道病毒116株,检出率为58.00%,其中RHV11株、RSV36株、INF-A37株、INF-B19株、PIV10株、ADV3株,检出率分别为5.5%、18.00%、18.50%、9.50%、5.00%、1.50%;肺功能分级I级患者病毒检出率为20.00%,II级为48.39%,III级为69.79%,IV级为82.35%,病毒检出率在不同肺功能AECOPD患者中比较差异具有统计学意义(P<0.05);肺功能分级与病毒检出率直线相关分析结果显示随着肺功能分级的严重程度增加患者咽试子呼吸道病毒检出率明显呈现增高趋势,两者直接具有正相关(r=0.67,P<0.05)。结论:COPD患者病情加重与病毒关系密切相关,病毒感染可能参与了COPD患者的病程进展。
Objective: To investigate the relativity between respiratory virus and acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in order to provide a reference for the diagnosis and treatment of AECOPD. Methods: A total of 200 AECOPD patients were selected as the research object to detect the lung function of patients. Luminex xMAP multiplex analysis platform was used to collect the patients’ pharyngeal testis. Multiplex PCR was performed to detect the rhinovirus (RHV), respiratory syncytial virus (RSV) Influenza virus A (INF-A), influenza virus B (INF-B), parainfluenza virus (PIV) and adenovirus (ADV). Results: There were 25 cases of grade I, 62 cases of grade II, 96 cases of grade III and 17 cases of grade IV in the 200 patients. The constituent ratios of them were 17.50%, 31.00%, 48.00% and 8.50% The detection rate of RHV11, RSV36, INF-A37, INF-B19, PIV10 and ADV3 were 5.5%, 18.00% and 18.50%, respectively. 9.50%, 5.00% and 1.50% respectively. The detection rate of virus in Grade I patients with pulmonary function grade was 20.00%, Grade II was 48.39%, Grade III was 69.79%, Grade IV was 82.35% (P <0.05). The linear correlation analysis of pulmonary function grade and virus detection rate showed that the detection rate of pharyngeal respiratory virus increased significantly with the increase of severity of pulmonary function classification, The two had a direct correlation (r = 0.67, P <0.05). Conclusion: The exacerbation of COPD patients is closely related to the virus. The viral infection may be involved in the course of disease in COPD patients.