慢性阻塞性肺疾病急性加重期痰培养细菌学分析(1)
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【摘要】 目的 探讨慢性阻塞性肺疾病(COPD)急性加重期痰细菌学状况以及细菌感染与肺功能损害、临床资料的关系。方法 对2007年8月至2009年7月114例COPD急性加重病例进行回顾性分析。结果 65例痰培养结果阳性者中有革兰阴性杆菌43株(66.15%);革兰阳性球菌16株(24.62%);革兰阴性球菌6株(9.23%)。细菌感染前4位依次是:铜绿假单胞菌12株(18.46%),肺炎克雷伯杆菌10株(15.38%),肺炎链球菌8株(12.31%),大肠埃希菌7株(10.77%)。FEV1%<50%及3个月内全身糖皮质激素应用时痰细菌培养阳性率,细菌分类与对应FEV1%≥50%、 无全身糖皮质激素应用时比较有统计学差异(P<0.05)。结论 对COPD急性加重期患者,呼吸道感染以革兰阴性细菌为主,痰细菌学培养结果与患者肺功能损害、三个月全身皮质激素应用关系密切。
【关键词】肺疾病;阻塞性;细菌;肺功能
Bacteriological culture Analysis of patients in acute exacerbation stage of chronic obstructive pulmonary disease
LIU Bin,ZHAO Jun,ZHOU Rui qing.Department of Respiratory,Fuyang People’s Hospital,Anhui Province 236003,China
【Abstract】 Objective To investigate the sputum bacteriology and the possible relationship among isolation of diverse bacteria pathogens in the sputum,functional respiratory impairment and clinical material of patients with acute exacerbations of COPD.Methods Retrospective surveys were carried out and the data were examined for 114 cases with acute exacerbations of COPD from 2007 to 2009.Results In these 65 cases of sputum bacteria culture positive patients,43 cases were affected by gram negative bacilli(66.15%),16 cases by gram positive coccus(24.62%),and 6 cases by gram negative coccus(9.23%).The most common four types bacteria affection were:12 strains of Pseudomonas aeruginosa(18.46%),10 strains of K.pneumoniae(15.38%),8 strains ofS.pneumoniae(12.31%),7 strains of Enteric bacilli(10.77%).The positive rate of sputum culture and bacteria classification had significant diference among the patients with FEV1%<50%and those with FEV1%≥50%,while there was statistical significance in the diference of the patients with or without systemic corticosteroids for nearly three months(P<0.05).Conclusion For the patients in acute exacerbation stage of COPD ,respiratory tract infection was mainly caused by gram negative bacteria,and the result of sputum bacteria culture has close relationship with the pulmonary function damage and systemic corticosteroids for nearly three months of patient ......
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