支气管扩张稳定期及急性加重期病原学特点及与气道炎症关系.docVIP

支气管扩张稳定期及急性加重期病原学特点及与气道炎症关系 　　[摘要] 目的 探讨支气管扩张稳定期及急性加重期病原学特点及与气道炎症的关系。 方法 选择2014年1月～2015年1月在沧州市中心医院就诊并保持随访完成整个实验的74例支气管扩张患者为研究对象，随访中有51例患者出现急性加重，对比分析支气管扩张稳定期及急性加重期患者的病原学特点、气道中性粒细胞及相关炎症因子水平，以及稳定期、急性加重期气道内细菌与气道炎症的关系。同时选择同期40名健康受试者作为正常对照。比较支气管扩张稳定期、急性加重期患者及正常对照气道中性粒细胞及相关炎症因子水平。 结果 支气管扩张急性加重期患者诱导痰细菌培养阳性率明显高于稳定期，差异有高度统计学意义（P 0.05）。急性加重期培养阳性的37例患者中有18例患者在稳定期已有细菌定植，而其中11例患者病原菌与稳定期细菌培养结果为同一细菌，其中铜绿假单胞菌6例，肺炎克雷伯菌3例，大肠埃希菌2例。支气管扩张患者稳定期及急性加重期气道中性粒细胞百分比、白介素-6（IL-6）、白介素-8（IL-8）肿瘤坏死因子-α（TNF-α）、白三烯B4（LTB4）水平均明显较健康受试者明显增高，差异均有高度统计学意义（P 0.01），而急性加重期患者各指标均高于稳定期，其中气道中性粒细胞百分比、IL-8、LTB4水平较稳定期明显升高，差异均有统计学意义（P 0.05或P 0.01）。稳定期和急性加重期细菌培养阳性患者诱导痰中性粒细胞百分比、IL-6、IL-8、TNF-α、LTB4值均明显高于细菌培养阴性患者，差异均有高度统计学意义（P 0.01）。 结论 支气管扩张患者急性加重期病原菌阳性率较稳定期定植菌检出率明显升高，而细菌种类无明显差别，但具有一定的关联；支气管扩张患者气道内存在以中性粒细胞为特征的气道炎性反应，且稳定期细菌定植、急性加重期病原菌感染者炎性反应程度明显高于细菌培养阴性者。 　　[关键词] 支气管扩张；病原学；气道；炎症 　　[中图分类号] R562.22 [文献标识码] A [文章编号] 1674-4721（2016）08（b）-0033-05 　　[Abstract] Objective To investigate the etiology characteristics of stable period and acute aggravating period of bronchiectasis and the relationship between airway inflammation. Methods Seventy-four patients with bronchiectasis who were treated in Central Hospital of Cangzhou and kept follow-up to complete the whole experiment were selected as the study objects， there were 51 cases patients with acute aggravating during follow-up. The etiology characteristics， airway neutrophils and related inflammatory factor levels of the stable period and acute aggravating period of bronchiectasis were contrastively analyzed， and the relationship between airway inflammation and airway bacteria of stable period and acute aggravating period were also analyzed. At the same time， 40 healthy subjects in the same period were chosen as the normal control. Levels of neutrophils and related inflammatory factor of airway in patients with in stable period and acute aggravating period of bronchiectasis and normal control were compared. Results The positive rate of induced sputum bacterial cultur