Lozo Vukovac Emilija, Miše Kornelija, Gudelj Ivan, Perić Irena, Duplančić Darko, Vuković Ivica, Vučinović Zoran, Lozo Mislav
1 Department of Pulmonary Diseases, University Hospital Center Split, Split, Croatia.
2 University of Split School of Medicine, Split, Croatia.
J Int Med Res. 2019 Feb;47(2):791-802. doi: 10.1177/0300060518811560. Epub 2018 Nov 29.
This study aimed to directly measure pH in the lungs, determine lactate dehydrogenase (LDH), C-reactive protein (CRP), and glucose levels in serum and bronchoalveolar aspirate, and identify bacterial pathogens from bronchoalveolar fluid during acute exacerbation of chronic obstructive pulmonary disease (AECOPD).
We performed an observational, analytical case-control study from February 2015 to March 2017. We included 84 patients with AECOPD and 42 with stable chronic obstructive pulmonary disease (COPD). All participants underwent detailed medical anamnesis, a clinical examination, chest radiography, spirometry, an arterial blood gas test, bronchoscopy, bacterial culture, and serum/bronchiolar aspirate laboratory testing.
The mean pH of bronchoalveolar fluid was significantly higher in patients with AECOPD than in patients with stable COPD. The mean lung pH value, bronchoalveolar and serum LDH levels, and serum CRP levels in patients with isolated bacteria were higher than those in patients without isolated bacteria in the AECOPD patient group. Lung pH values in patients with AECOPD were significantly correlated with bronchoalveolar LDH and glucose levels.
AECOPD is associated with local cell and tissue injury in the lungs, especially in the presence of bacterial pathogens, which is accompanied by a low systemic inflammatory response.
本研究旨在直接测量肺部的pH值，测定血清和支气管肺泡灌洗液中的乳酸脱氢酶（LDH）、C反应蛋白（CRP）和葡萄糖水平，并在慢性阻塞性肺疾病急性加重期（AECOPD）期间从支气管肺泡液中鉴定细菌病原体。
我们在2015年2月至2017年3月期间进行了一项观察性、分析性病例对照研究。我们纳入了84例AECOPD患者和42例稳定期慢性阻塞性肺疾病（COPD）患者。所有参与者均接受了详细的病史采集、临床检查、胸部X线摄影、肺功能测定、动脉血气分析、支气管镜检查、细菌培养以及血清/支气管肺泡灌洗液实验室检测。
AECOPD患者支气管肺泡液的平均pH值显著高于稳定期COPD患者。AECOPD患者组中分离出细菌的患者的平均肺pH值、支气管肺泡和血清LDH水平以及血清CRP水平高于未分离出细菌的患者。AECOPD患者的肺pH值与支气管肺泡LDH和葡萄糖水平显著相关。
AECOPD与肺部局部细胞和组织损伤有关，尤其是在存在细菌病原体的情况下，同时伴有低全身炎症反应。
