Tufvesson Ellen, Bjermer Leif, Ekberg Marie
Respiratory Medicine and Allergology, Department of Clinical Sciences, Lund University, Lund, Sweden.
Int J Chron Obstruct Pulmon Dis. 2015 May 4;10:881-9. doi: 10.2147/COPD.S78748. eCollection 2015.
Some patients with chronic obstructive pulmonary disease (COPD) show increased airway inflammation and bacterial colonization during stable phase. The aim of this study was to follow COPD patients and investigate chronic colonization with pathogenic bacteria during stable disease phase, and relate these findings to clinical parameters, inflammatory pattern, lung function, and exacerbations.
Forty-three patients with COPD were included while in a stable state and followed up monthly until exacerbation or for a maximum of 6 months. The patients completed the Clinical COPD Questionnaire and Medical Research Council dyspnea scale questionnaires, and exhaled breath condensate was collected, followed by spirometry, impulse oscillometry, and sputum induction.
Ten patients were chronically colonized (ie, colonized at all visits) with Haemophilus influenzae during stable phase. These patients had higher sputum levels of leukotriene B4 (P<0.001), 8-isoprostane (P=0.002), myeloperoxidase activity (P=0.028), and interleukin-8 (P=0.02) during stable phase when compared with other patients. In addition, they had lower forced vital capacity (P=0.035) and reactance at 5 Hz (P=0.034), but there was no difference in forced expiratory volume in 1 second (FEV1), FEV1 % predicted, forced vital capacity % predicted, exhaled breath condensate biomarkers, C-reactive protein, or Clinical COPD Questionnaire and Medical Research Council dyspnea scale results. Three patients had intermittent colonization (colonized at only some visits) of H. influenzae during stable phase, and had lower levels of inflammatory biomarkers in sputum when compared with the chronically colonized patients. The difference in airway inflammation seen during stable phase in patients chronically colonized with H. influenzae was not observed during exacerbations.
Some COPD patients who were chronically colonized with H. influenzae during stable phase showed increased airway inflammation and reduced lung volumes when compared with non-chronically colonized patients.
一些慢性阻塞性肺疾病（COPD）患者在稳定期气道炎症和细菌定植增加。本研究的目的是随访COPD患者，调查疾病稳定期病原菌的慢性定植情况，并将这些发现与临床参数、炎症模式、肺功能和急性加重情况相关联。
纳入43例处于稳定状态的COPD患者，每月随访直至急性加重或最长随访6个月。患者完成慢性阻塞性肺疾病临床问卷和医学研究委员会呼吸困难量表问卷，并收集呼出气冷凝物，随后进行肺量计检查、脉冲振荡法检查和痰液诱导检查。
10例患者在稳定期被流感嗜血杆菌慢性定植（即所有访视时均有定植）。与其他患者相比，这些患者在稳定期痰液中白三烯B4（P<0.001）、8-异前列腺素（P=0.002）、髓过氧化物酶活性（P=0.028）和白细胞介素-8（P=0.02）水平更高。此外，他们的用力肺活量较低（P=0.035），5 Hz时的电抗较低（P=0.034），但1秒用力呼气量（FEV1）、预测FEV1%、预测用力肺活量%、呼出气冷凝物生物标志物、C反应蛋白或慢性阻塞性肺疾病临床问卷及医学研究委员会呼吸困难量表结果无差异。3例患者在稳定期有流感嗜血杆菌间歇性定植（仅在部分访视时有定植），与慢性定植患者相比，其痰液中炎症生物标志物水平较低。在急性加重期未观察到流感嗜血杆菌慢性定植患者在稳定期出现的气道炎症差异。
与非慢性定植患者相比，一些在稳定期被流感嗜血杆菌慢性定植的COPD患者气道炎症增加，肺容积减小。
