Relationship between pathogen and lung function in patients with acute exacerbations of COPD_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 XU jianying , LI xiaoyan , DU yongcheng , YANG Lili , WANG Shufeng , WANG hong

Department of Respiratory Medicine，The First Hospital of Shanxi Medical University.Taiyuan，Shanxi，030001，China;

Corresponding author：

XU jianying, Email: xujyty@tom.com

Keywords：

Chronic obstructive pulmonary disease; Pathogen; Lung function

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Objectives To investigate the pathogenic characteristics and the possible relationship between pathogen and respiratory function in patients with acute exacerbations of COPD (AECOPD).Methods Sixty-four patients with AECOPD were investigated with lung function test，quantitative and qualitative sputum bacteria culture，drug sensitive test，and Mycoplasma pneumoniae and Chlamydia pneumoniae specific antibodies test.The patients were divided into three groups according to FEV1%pred，50%≤FEV1 lt;80%pred for the Group One，30%pred≤FEV1 lt;50%pred for the Group Two，and FEV1 lt;30%pred for the Group Three.Meanwhile according to the result of sputum culture，infective bacteria were divided into four kinds： Gram-positive cocci for kind A，Gram-negtive germ except kind C for kind B，Acinetobacter，Enterobacter and Pseudomonas spp for kind C，and negative result for kind D.Results ⑴Of 64 patients who were conducted quantitative sputum culture，germs isolated were mostly Streptococcus pneumoniae，Enterobacter，Moraxella Catarrhalis，and Pseudomonas.Of 38 patients who were conducted qualitative sputum culture，most of them were found mixed infection，and germs isolated were mostly Streptococcus pneumoniae，Staphylococcus epidermidis，Acinetobacter and Enterobacter.⑵Both quantitative and qualitative sputum culture revealed that Most of Group One patients were not infected by bacteria，and the Group Three patients were mainly by resistant kind A and kind C bacteria (P lt;0.01 and 0.05 respectively).⑶The infection of Mycoplasma pneumoniae or Chlamydia pneumoniae was identified in 29.4% of the cases.Conclusions There is a close correlation between the degree of functional damage and the infected bacterial strains for patients with AECOPD，the more chance of bacteria infection such as S pneumoniae，Acinetobacter，Enterobacter and Pseudomonas，the more damage of lung function.

Citation： XU jianying,LI xiaoyan,DU yongcheng,YANG Lili,WANG Shufeng,WANG hong. Relationship between pathogen and lung function in patients with acute exacerbations of COPD. Chinese Journal of Respiratory and Critical Care Medicine, 2007, 6(2): 88-93. doi: Copy

1.	赵鸣武.重视对慢性阻塞性肺疾病急性加重的病因学及其对策的研究.中国呼吸与危重监护杂志，2004，3：67.
2.	Eller J，Ede A，Schaberg T，et al.Infective exacerbations of chronic bronchitis： relation between bacteriologic etiology and lung function.Chest，1998，113：1542-1548.
3.	Monso E，Ruiz J，Rosell A，et al.Bacterial infection in chronic obstructive pulmonary disease.Am J Respir Crit Care Med，1995，152：1316-1320.
4.	中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南.中华内科杂志，2002，41：640-646.
5.	熊彬，王荣丽，曹乃清，等.慢性阻塞性肺疾病急性加重期痰细菌培养与肺功能关系探讨.实用心脑肺血管病杂志，2004，12：83-85.
6.	Miravitlles M，Espinosa C，Fernandez-Laso E，et al.Relationship between bacterial flora in sputum and functional impairment in patients with acute exacerbations of COPD.Study Group of Bacterial Infection in COPD.Chest，1999，116：40-46.
7.	马春玲，张纪云，夏丽华.口痰细菌定量培养方法及其应用.临沂医专学报，1995，17：293-294.
8.	陈慧生，李庆棣，梁冰.简化痰细菌定量培养法的临床应用和评价.临床荟萃，1994，9：570-572.
9.	霍建民，杨光，张俊梅，等.COPD患者急性加重期细菌学与肺功能关系的初步研究.中国急救医学，2002，22：35.
10.	林英翔，王辰，杜小玲，等.慢性阻塞性肺病急性加重期痰细菌学培养与肺功能的关系.中华医院感染学杂志，2002，12：182-183.
11.	刘又宁，陈民钧，赵铁梅，等.中国城市成人社区获得性肺炎665例病原学多中心调查.中华结核和呼吸杂志，2006，29：3-8.
12.	杨文杰，陶家驹，卫京平，等.慢性阻塞性肺疾病急性发作病原学及临床特点分析.中华临床医药，2003，4：49-51.
13.	何礼贤，李锡莹.下呼吸道感染的细菌学诊断方法评价.中华结核和呼吸杂志，1987，10：183-186.
14.	Kilbourn JP，Campbell RA，Grach JL，et al.Quantitative bacteriology of sputum.Am Rev Respir Dis，1968，98：810-818.
15.	Hill AT，Campbell EJ，Hill SL，et al.Association between airway bacterial load and markers of airway inflammation in patients with stable chronic bronchitis.Am J Med，2000，109：288-295.
16.	Sethi S，Muscarella K，Evans N，et al.Airway inflammation and etiology of acute exacerbations of chronic bronchitis.Chest，2000，118：1557-1565.
17.	Miravitlles M.Exacerbations of chronic obstructive pulmonary disease：when are bacteria important? Eur Respir J，2002，36：9s-19s.

1. 赵鸣武.重视对慢性阻塞性肺疾病急性加重的病因学及其对策的研究.中国呼吸与危重监护杂志，2004，3：67.
2. Eller J，Ede A，Schaberg T，et al.Infective exacerbations of chronic bronchitis： relation between bacteriologic etiology and lung function.Chest，1998，113：1542-1548.
3. Monso E，Ruiz J，Rosell A，et al.Bacterial infection in chronic obstructive pulmonary disease.Am J Respir Crit Care Med，1995，152：1316-1320.
4. 中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南.中华内科杂志，2002，41：640-646.
5. 熊彬，王荣丽，曹乃清，等.慢性阻塞性肺疾病急性加重期痰细菌培养与肺功能关系探讨.实用心脑肺血管病杂志，2004，12：83-85.
6. Miravitlles M，Espinosa C，Fernandez-Laso E，et al.Relationship between bacterial flora in sputum and functional impairment in patients with acute exacerbations of COPD.Study Group of Bacterial Infection in COPD.Chest，1999，116：40-46.
7. 马春玲，张纪云，夏丽华.口痰细菌定量培养方法及其应用.临沂医专学报，1995，17：293-294.
8. 陈慧生，李庆棣，梁冰.简化痰细菌定量培养法的临床应用和评价.临床荟萃，1994，9：570-572.
9. 霍建民，杨光，张俊梅，等.COPD患者急性加重期细菌学与肺功能关系的初步研究.中国急救医学，2002，22：35.
10. 林英翔，王辰，杜小玲，等.慢性阻塞性肺病急性加重期痰细菌学培养与肺功能的关系.中华医院感染学杂志，2002，12：182-183.
11. 刘又宁，陈民钧，赵铁梅，等.中国城市成人社区获得性肺炎665例病原学多中心调查.中华结核和呼吸杂志，2006，29：3-8.
12. 杨文杰，陶家驹，卫京平，等.慢性阻塞性肺疾病急性发作病原学及临床特点分析.中华临床医药，2003，4：49-51.
13. 何礼贤，李锡莹.下呼吸道感染的细菌学诊断方法评价.中华结核和呼吸杂志，1987，10：183-186.
14. Kilbourn JP，Campbell RA，Grach JL，et al.Quantitative bacteriology of sputum.Am Rev Respir Dis，1968，98：810-818.
15. Hill AT，Campbell EJ，Hill SL，et al.Association between airway bacterial load and markers of airway inflammation in patients with stable chronic bronchitis.Am J Med，2000，109：288-295.
16. Sethi S，Muscarella K，Evans N，et al.Airway inflammation and etiology of acute exacerbations of chronic bronchitis.Chest，2000，118：1557-1565.
17. Miravitlles M.Exacerbations of chronic obstructive pulmonary disease：when are bacteria important? Eur Respir J，2002，36：9s-19s.

Chinese Journal of Respiratory and Critical Care Medicine

Relationship between pathogen and lung function in patients with acute exacerbations of COPD

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