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目的探讨肺炎支原体(MP)感染与慢性阻塞性肺病(COPD)的相关性及急性加重期COPD患者(AECOPD)MP感染的易感因素。方法选取门诊2012年6月-2013年6月就诊的COPD患者124例为研究对象,根据患者病情分为COPD稳定期48例以及COPD急性加重期76例,选取100例健康体检者为对照组,采用免疫荧光法测定各组MP抗体。结果 COPD组患者MP-IgM、MP-IgG抗体阳性率显著高于对照组,而AECOPD组MP-IgM、MP-IgG抗体阳性率高于稳定期COPD组,差异有统计学意义(P<0.05)。AECOPD组中MP阳性感染患者咳嗽、发热、肺部罗音、心力衰竭、脓痰发生率显著高于MP阴性组,差异有统计学意义(P<0.05),而COPD稳定期患者MP(+)咳嗽、发热、肺部罗音、心力衰竭、脓痰发生率与MP(-)相比差异无统计学意义(P>0.05)。经单因素分析可知,导致AECOPD患者MP感染的易感的相关因素包括年龄、白细胞增加、合并肺心病、病程。结论 MP感染可能是引起COPD病情进展的重要原因,尤其对于年龄较大、合并肺心病、白细胞增加、病情较长的患者更容易感染MP。
Objective To investigate the relationship between Mycoplasma pneumoniae (MP) infection and chronic obstructive pulmonary disease (COPD) and susceptibility to MP infection in acute exacerbation COPD patients (AECOPD). Methods A total of 124 outpatients with COPD from June 2012 to June 2013 were selected as study subjects. According to the patients’ condition, they were divided into stable COPD (48 cases) and acute exacerbation of COPD (76 cases). 100 healthy subjects were selected as control group, Immunofluorescence method was used to detect MP antibody in each group. Results The positive rates of MP-IgM and MP-IgG in COPD group were significantly higher than those in control group. The positive rates of MP-IgM and MP-IgG in AECOPD group were significantly higher than those in stable COPD group (P <0.05) . The incidence of cough, fever, pulmonary rales, heart failure and purulent sputum in patients with MP positive infection in AECOPD group was significantly higher than that in MP negative group (P <0.05) Cough, fever, pulmonary rales, heart failure, purulent sputum incidence and MP (-) compared with no significant difference (P> 0.05). Univariate analysis shows that the susceptibility factors associated with MP infection in patients with AECOPD include age, leukocytosis, pulmonary heart disease, duration of disease. Conclusion MP infection may be an important cause of COPD progression, especially for older patients with pulmonary heart disease, leukocytosis, and longer illness.