中国广州稳定期支气管扩张症患者痰液细菌学研究

Sputum bacteriology in steady-state bronchiectasis in Guangzhou, China.

作者信息

Guan W-J, Gao Y-H, Xu G, Lin Z-Y, Tang Y, Li H-M, Lin Z-M, Zheng J-P, Chen R-C, Zhong N-S

机构信息

State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.

Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.

出版信息

Int J Tuberc Lung Dis. 2015 May;19(5):610-9. doi: 10.5588/ijtld.14.0613.

DOI:10.5588/ijtld.14.0613

PMID:25868032

Abstract

BACKGROUND

The impact of potentially pathogenic micro-organisms (PPMs) on Chinese patients with steady-state bronchiectasis is unknown.

METHODS

Peripheral blood and sputum were sampled to determine inflammatory markers and sputum bacterial density. Spirometry and diffusing capacity were measured. Quality of life was assessed using the St George's Respiratory Questionnaire.

RESULTS

Of 144 patients with steady-state bronchiectasis, Pseudomonas aeruginosa was isolated in 44 cases (30.6%). Compared with other PPMs, P. aeruginosa had a more pronounced influence on airway inflammation and spirometry, but not on systemic inflammation or quality of life. The impact of PPMs other than P. aeruginosa on clinical indices was similar. Bacterial density was not correlated with most clinical parameters. Factors associated with PPM isolation included bronchiectasis symptoms for ⩾ 10 years (OR 2.13) and ⩾ 4 bronchiectatic lobes (OR 2.82). Having ⩾ 4 exacerbations within 2 years (OR 2.18) and cystic bronchiectasis (OR 2.23) was associated with the colonisation of PPMs, i.e., isolating an identical PPM on at least two occasions within 1 year.

CONCLUSION

In patients with steady-state bronchiectasis in Guangzhou, P. aeruginosa is the most common organism causing heightened airway inflammation and poor lung function. PPM isolation or colonisation should be suspected in case of longer duration of symptoms, multilobar bronchiectasis, frequent exacerbation and cystic bronchiectasis.

摘要

背景

潜在致病微生物（PPMs）对中国稳定期支气管扩张症患者的影响尚不清楚。

方法

采集外周血和痰液样本以测定炎症标志物和痰液细菌密度。测量肺功能和弥散功能。使用圣乔治呼吸问卷评估生活质量。

结果

在144例稳定期支气管扩张症患者中，44例（30.6%）分离出铜绿假单胞菌。与其他PPMs相比，铜绿假单胞菌对气道炎症和肺功能的影响更为显著，但对全身炎症或生活质量无影响。铜绿假单胞菌以外的PPMs对临床指标的影响相似。细菌密度与大多数临床参数无关。与PPM分离相关的因素包括支气管扩张症状持续≥10年（比值比2.13）和支气管扩张叶≥4个（比值比2.82）。2年内发作≥4次（比值比2.18）和囊状支气管扩张（比值比2.23）与PPMs定植有关，即在1年内至少两次分离出相同的PPM。