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目的探究结核感染对慢性阻塞性肺疾病急性加重期(AECOPD)的影响,为降低肺部感染提供依据。方法对2012年1月-2013年6月145例慢性阻塞性肺疾病(COPD),因急性加重入院患者临床资料进行分析,根据AECOPD合并肺部结核感染分为观察组74例,未出现肺结核感染为对照组71例,对比两组患者白细胞(WBC)、中性粒细胞(N)、淋巴细胞(L)、C-反应蛋白(CRP)等感染指标,血红蛋白(Hb)、淋巴细胞计数(TLC)、血清白蛋白(ALB)、体质量指数(BMI)等营养指标以及其他临床症状。结果观察组的WBC、N、Hb、ALB及BMI均低于对照组,L、CRP、TLC高于对照组;观察组出现咯血、胸痛以及肺部感染等临床症状的分布率,分别为16.22%、10.81%、36.49%,高于对照组的2.82%、1.41%、5.63%;差异均有统计学意义(P<0.05)。结论伴有结核感染的AECOPD患者WBC、CRP等指标变化明显,并且临床上发生咯血等严重临床症状的概率更大。
Objective To investigate the impact of tuberculosis infection on acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and to provide basis for reducing pulmonary infection. Methods From January 2012 to June 2013, 145 patients with chronic obstructive pulmonary disease (COPD) who were admitted to hospital due to acute exacerbation were analyzed. According to AECOPD, pulmonary tuberculosis was divided into observation group (74 cases) and no pulmonary tuberculosis infection (Control group, n = 71). WBC, neutrophil count, lymphocyte count and C-reactive protein were compared between the two groups. The indexes of hemoglobin (Hb), lymphocyte count ), Serum albumin (ALB), body mass index (BMI) and other nutritional indicators and other clinical symptoms. Results The WBC, N, Hb, ALB and BMI in the observation group were lower than those in the control group, while the levels of L, CRP and TLC in the observation group were higher than those in the control group. The distribution rates of clinical symptoms such as hemoptysis, chest pain and pulmonary infection in the observation group were 16.22% , 10.81% and 36.49% respectively, higher than that of the control group (2.82%, 1.41% and 5.63%, respectively). The difference was statistically significant (P <0.05). Conclusion The WBC, CRP and other indicators of patients with AECOPD accompanied by tuberculosis infection have obvious changes, and the clinical probability of occurrence of severe clinical symptoms such as hemoptysis is greater.