目的 探討COPD 患者并發(fā)持續(xù)喘息與痰真菌培養(yǎng)陽性之間的相關(guān)性。方法 收集2005 年1 月～2007 年12 月于上海交通大學附屬第一人民醫(yī)院、復旦大學附屬中山醫(yī)院、復旦大學附屬華東醫(yī)院3 家醫(yī)院呼吸科住院的COPD 急性加重患者的病史資料, 進行回顧性分析。結(jié)果 共收集到符合入選標準的COPD 持續(xù)喘息組患者35 例, COPD非喘息組患者43 例。持續(xù)喘息組中32 例( 91. 4% ) 痰真菌培養(yǎng)陽性, 非喘息組中11 例( 25. 6% ) 陽性, 兩組比較差異顯著( P lt;0. 01) 。細菌陽性率無顯著差異( 28. 6% 比39. 5% , P gt;0. 05) 。在真菌的菌種構(gòu)成方面, 持續(xù)喘息組32 例痰真菌陽性患者中曲霉陽性12 例, 非喘息組11 例痰真菌陽性患者中未檢出曲霉, 曲霉在兩組中分布有顯著差異( P lt;0. 05) 。持續(xù)喘息組抗真菌治療后癥狀緩解率顯著高于未抗真菌治療者( 81. 0% 比36. 4% ,P lt;0. 05) 。結(jié)論 COPD 患者并發(fā)持續(xù)喘息與真菌, 特別是曲霉在氣道內(nèi)定植感染有關(guān)。
引用本文： 祁卉卉,謝國鋼,高福生,金先橋. COPD并發(fā)持續(xù)喘息與痰真菌培養(yǎng)陽性的相關(guān)分析. 中國呼吸與危重監(jiān)護雜志, 2009, 09(2): 114-116. doi: 復制
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- 1. 白沖. 慢性阻塞性肺疾病的危險因素、流行情況及未來發(fā)展趨勢. 中國呼吸與危重監(jiān)護雜志, 2007, 6: 403-404.
- 2. 劉春濤, 馮玉麟. 慢性阻塞性肺疾病急性加重研究進展. 中國呼吸與危重監(jiān)護雜志, 2007, 6: 405-409.
- 3. 中華醫(yī)學會呼吸病學分會慢性阻塞性肺疾病學組. 慢性阻塞性肺疾病診治指南. 中華內(nèi)科雜志, 2002, 41, 640-646.
- 4. Rabe KF, Hurd S, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med, 2007, 176: 532-555.
- 5. FischerG,SchwabeR,M ller M, et al. Species-specific production of microbial volatile organic compounds ( MVOC) by airborne fungi from a compost facility. Chemosphere, 1999, 39: 795-810 .
- 6. Alamoudi OS. Bacterial infection and risk factors in outpatients with acute exacerbation of chronic obstructive pulmonary disease: a 2 -year prospective study. Respirology, 2007, 12: 283-287.
- 7. Burley CJ, Masterton RG, Lovell DP. Indicators of bacterial infection in patients with acute exacerbation of chronic bronchitis for application in clinical trials of antibacterial drugs. J Infect, 2007 ,55: 226-232.
- 8. 侯天文, 陳興, 張健, 等, COPD患者急性發(fā)作期下呼吸道病原菌群分布與耐藥分析. 中國感染控制雜志, 2006, 5, 174-175.
- 9. Soler N, AgustíC, Angrill J, et al. Bronchoscopic validation of the significance of sputum purulence in severe exacerbations of chronic obstructive pulmonary disease. Thorax, 2007, 62: 29-35.
- 10. Pappas GP, Herbert RJ, Henderson W, et al. The respiratory effects of volatile organic compounds. Int JOccup Environ Health, 2000, 6 :1-8.
- 11. 劉玲, 李曉靜. 老年慢性阻塞性肺疾病急性加重期肺部真菌感染的臨床分析. 中國臨床保健雜志, 2007, 10, 597-599.