Jonsson J S, Sigurdsson J A, Kristinsson K G, Guthnadóttir M, Magnusson S
Gardabaer Community Health Centre, University of Iceland, Reykjavik, Iceland.
Scand J Prim Health Care. 1997 Sep;15(3):156-60. doi: 10.3109/02813439709018507.
To investigate how close we can come to the aetiology of acute bronchitis in adults in a primary care setting.
Prospective study.
General practice population in Gardabaer district, south-western Iceland.
140 patients > or = 16 years old who were diagnosed as having acute bronchitis during a two-year period (1992-1993).
Laboratory investigations (twice with a minimum four-week interval), used in general practice to analyse respiratory tract infections. They included serology for Chlamydia pneumoniae, Mycoplasma pneumoniae, respiratory tract viruses, and the level of C-reactive protein.
Of a total of 140 patients, two blood samples were taken on scheduled time in 113 patients. Serology confirmed recent infection in 18 (16%) of these patients. Only two (2%) had a bacterial infection (one C. pneumoniae, one M. pneumoniae). The others (84%) did not have a significant increase in antibody titres. Only four (4%) had C-reactive protein levels higher than 48 mg/l.
The study indicates that it is difficult to come close to a precise aetiology with respect to infectious agents of acute bronchitis in general practice. We conclude that the disease is rarely caused by atypical bacteria such as C. pneumoniae and M. pneumoniae, and rarely caused by bacterial infections severe enough significantly to increase the level of C-reactive protein.
在初级保健机构中研究我们能在多大程度上接近成人急性支气管炎的病因。
前瞻性研究。
冰岛西南部加德拜尔区的全科医疗人群。
在两年期间（1992 - 1993年）被诊断为患有急性支气管炎的140名年龄≥16岁的患者。
用于全科医疗中分析呼吸道感染的实验室检查（间隔至少四周进行两次）。包括肺炎衣原体、肺炎支原体、呼吸道病毒的血清学检查以及C反应蛋白水平。
在总共140名患者中，113名患者按时采集了两份血样。血清学检查证实其中18名（16%）患者近期感染。只有两名（2%）患者有细菌感染（一名肺炎衣原体感染，一名肺炎支原体感染）。其他患者（84%）抗体滴度没有显著升高。只有四名（4%）患者的C反应蛋白水平高于48mg/l。
该研究表明，在全科医疗中很难确切了解急性支气管炎感染病原体的精确病因。我们得出结论，该疾病很少由肺炎衣原体和肺炎支原体等非典型细菌引起，也很少由严重到足以显著提高C反应蛋白水平的细菌感染引起。
