CAJ | 학술논문

目的比较慢性阻塞性肺疾病(简称慢阻肺)患者鼻部及下气道标本的鼻病毒检出率及病毒载量的差异,为临床检测标本类型的选择提供参考依据.方法收集慢阻肺患者的鼻拭子(鼻部)及诱导痰(下气道)标本,包括急性加重期标本及稳定期标本,采用荧光定量PCR法进行鼻病毒检测.分别比较急性期及稳定期标本鼻病毒检出率、鼻拭子及诱导痰标本鼻病毒检出率及鼻病毒阳性配对的鼻拭子及诱导痰标本的鼻病毒载量.结果 2009年9月至2013年1月共收集来源于慢阻肺患者的鼻拭子标本及诱导痰标本639对,其中114对匹配的急性期及稳定期标本(鼻拭子及诱导痰),余411对只有稳定期标本(由于患者未出现急性加重,故无相匹配的急性期标本).匹配的114对稳定期及急性期标本鼻病毒检测结果显示,急性期鼻拭子标本鼻病毒的阳性率为13.2％(15/114),高于稳定期的3.5％ (4/114,P＜0.05)；急性期诱导痰标本鼻病毒的阳性率为21.9％ (25/114),亦显著高于稳定期的5.3％(6/114,P＜0.01).639对鼻拭子及诱导痰标本的检测结果显示,鼻拭子鼻病毒的检出率为6.6％(43/639),诱导痰标本鼻病毒的检出率为9.1％(58/639),两者检出率比较差异有统计学意义(P＜0.05),其中匹配的27对鼻拭子及诱导痰标本均检出鼻病毒,诱导痰标本鼻病毒载量为(62.1±9.5) ×108拷贝/L,高于鼻拭子标本的(3.38 ±0.52)×108拷贝/L,差异有统计学意义(P＜0.05).结论对于慢阻肺患者,诱导痰标本比鼻拭子更适合于鼻病毒检测,鼻病毒在下气道的载量高于上气道.
목적 비교만성조새성폐질병(간칭만조폐)환자비부급하기도표본적비병독검출솔급병독재량적차이,위림상검측표본류형적선택제공삼고의거.방법 수집만조폐환자적비식자(비부)급유도담(하기도)표본,포괄급성가중기표본급은정기표본,채용형광정량PCR법진행비병독검측.분별비교급성기급은정기표본비병독검출솔、비식자급유도담표본비병독검출솔급비병독양성배대적비식자급유도담표본적비병독재량.결과 2009년9월지2013년1월공수집래원우만조폐환자적비식자표본급유도담표본639대,기중114대필배적급성기급은정기표본(비식자급유도담),여411대지유은정기표본(유우환자미출현급성가중,고무상필배적급성기표본).필배적114대은정기급급성기표본비병독검측결과현시,급성기비식자표본비병독적양성솔위13.2％(15/114),고우은정기적3.5％ (4/114,P＜0.05)；급성기유도담표본비병독적양성솔위21.9％ (25/114),역현저고우은정기적5.3％(6/114,P＜0.01).639대비식자급유도담표본적검측결과현시,비식자비병독적검출솔위6.6％(43/639),유도담표본비병독적검출솔위9.1％(58/639),량자검출솔비교차이유통계학의의(P＜0.05),기중필배적27대비식자급유도담표본균검출비병독,유도담표본비병독재량위(62.1±9.5) ×108고패/L,고우비식자표본적(3.38 ±0.52)×108고패/L,차이유통계학의의(P＜0.05).결론 대우만조폐환자,유도담표본비비식자경괄합우비병독검측,비병독재하기도적재량고우상기도.
Objective To compare the rhinovirus detection rate and the viral load in nasal samples versus lower airway samples from patients with COPD,and therefore to provide evidence for sampling selection for detection of rhinovirus.Methods Nasal swab and induced sputum were collected from patients with COPD during acute exacerbation and the stable period.Rhinovirus was detected by real-time fluorescent quantitative polymerase chain reaction.The difference in detection rates of rhinovirus between acute exacerbation and stable COPD was compared.The detection rates and the viral load from nasal samples versus induced sputum were also compared.Results A total of 639 paired nasal swab and induced sputum specimens were collected between September 2009 and January 2013,including 114 paired specimens from COPD patients with acute exacerbations 114 paired specimens from stable COPD (matching with the stable one),and 411 paired specimens from stable COPD patients.For the 114 paired samples from stable and acute COPD patients,there was a higher detection rate in samples [nasal swab 13.2％ (15/114),induced sputum 21.9％ (25/114)] from patients with acute exacerbation,compared those with stable disease [nasal swab 3.5％ (4/114),P ＜ 0.05 ; and induced sputum 5.3％ (6/114) P ＜ 0.01,respectively].Forty-two (6.6％) of the 639 nasal swab specimens were positive for rhinovirus,while 58 (9.1％) of the 639 induced sputum specimens were positive for rhinovirus (P ＜ 0.05).For the 27 paired rhinovirus positive specimens,the mean viral load of rhinovirus in induced sputum was (62.1 ± 9.5) × 108 copies/L,significantly higher than that of the nasal swab (3.4 ± 0.5) × 108 copies/L,P ＜ 0.05.Conclusion For patients with COPD,induced sputum specimens may be more suitable for rhinovirus detection compared to nasal swabs,and the load of rhinovirus was higher in the lower airways than in the upper airways.