CAJ | 학술논문

目的：观察慢性阻塞性肺疾病急性加重期（AECOPD）老年患者的病毒感染状况，分析其临床特征，为临床防治AECOPD提供参考依据。方法选取2011年1月－2013年12月郑州市中医院收治的78例AECOPD老年患者为研究对象，采用套式多重反转录‐聚合酶链反应（RT‐PCR）检测病毒感染，根据结果将所有患者分为病毒感染阳性组28例和阴性组50例，分析病毒感染与患者临床特征的关系。结果78例患者中28例病毒检测结果阳性，阳性率为35．9％，其中鼻病毒（hRV）的检出率最高；logistic多元回归分析结果表明，合并糖尿病及呼吸衰竭是AECOPD老年患者并发病毒感染的独立影响因素，阳性组患者的血压舒张压明显高于阴性组（P＜0．05），其余临床表现、全部辅助结果以及总住院时间比较差异无统计学意义，阳性组患者有4例死亡，阴性组无患者死亡，两组病死率比较差异有统计学意义（P＜0．05）。结论 hRV是AECOPD老年患者病毒感染最常检出的病毒，合并糖尿病及呼吸衰竭均可以增加患者感染病毒的风险，病毒感染增加了患者的病死率，但患者缺乏特异性的临床表现。
목적：관찰만성조새성폐질병급성가중기（AECOPD）노년환자적병독감염상황，분석기림상특정，위림상방치AECOPD제공삼고의거。방법선취2011년1월－2013년12월정주시중의원수치적78례AECOPD노년환자위연구대상，채용투식다중반전록‐취합매련반응（RT‐PCR）검측병독감염，근거결과장소유환자분위병독감염양성조28례화음성조50례，분석병독감염여환자림상특정적관계。결과78례환자중28례병독검측결과양성，양성솔위35．9％，기중비병독（hRV）적검출솔최고；logistic다원회귀분석결과표명，합병당뇨병급호흡쇠갈시AECOPD노년환자병발병독감염적독립영향인소，양성조환자적혈압서장압명현고우음성조（P＜0．05），기여림상표현、전부보조결과이급총주원시간비교차이무통계학의의，양성조환자유4례사망，음성조무환자사망，량조병사솔비교차이유통계학의의（P＜0．05）。결론 hRV시AECOPD노년환자병독감염최상검출적병독，합병당뇨병급호흡쇠갈균가이증가환자감염병독적풍험，병독감염증가료환자적병사솔，단환자결핍특이성적림상표현。
OBJECTIVE To observe the prevalence of viral infections in the elderly patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and analyze the clinical characteristics so as to provide guid‐ance for clinical treatment of AECOPD .METHODS A total of 78 elderly patients with AECOPD who were treated in Zhengzhou City Hospital of Traditional Chinese Medicine from Jan 2011 to Dec 2013 were recruited as the study objects ,then the viral infections were detected by using nested multiplex reverse transcription polymerase chain re‐action (RT‐PCR) .All cases were divided into the positive viral infection group with 28 cases and the negative viral infection group with 50 cases;the relationship between the viral infections and the clinical characteristics was ob‐served .RESULTS Of the 78 patients ,28 were positive for viral test with the positive rate of 35 .9% ,and the detec‐tion rate of rhinovirus (hRV) was the highest .The results of multivariate logistic regression analysis indicated that the complication of diabetic mellitus and respiratory failure were the independent risk factors for the complicated viral infections in the elderly patients with AECOPD ,and the diastolic blood pressure of the positive group was significantly higher than that of the negative group (P<0 .05) ,there was no significant difference in other clinical manifestations ,all auxiliary results ,or total length of hospital stay .Totally 4 cases died in the positive group , while no case died in the negative group ,and there was significant difference in the mortality rate between the two groups (P<0 .05) .CONCLUSION The hRV is the most common virus isolated from the elderly patients with AE‐COPD ;the complication of diabetic mellitus and respiratory failure may increase the risk of the viral infections , which leads to the increase of the mortality rate ,however ,the patients are attribute to lack of specific clinical manifestations .