临床误诊误治2026，Vol.39Issue(1)：30-37,8.DOI:10.3969/j.issn.1002-3429.2026.01.006
慢性阻塞性肺疾病急性加重期患者多重耐药菌感染病原学分布及与Th1/Th2细胞因子含量的关系
Etiological distribution of multidrug-resistant organism infection in patients with acute exacerbation of chronic obstructive pulmonary disease and its relationship with Th1/Th2 cytokine content
摘要
Abstract
Objective To investigate the etiological distribution of multidrug-resistant organism(MDRO)infection and its relationship with Th1/Th2 cytokine levels in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Two hundred patients with AECOPD admitted from April 2022 to July 2024 were selected as the research subjects.The MDRO infection and etiological distribution were recorded.According to presence of MDRO infection,they were divided into MDRO group and non-MDRO group.The general data and Th1/Th2 cytokine level of the two groups were compared,to analyze the correlation between Th1/Th2 cytokines and clinical characteristics.Multivariate logistic regression was used to analyze the influencing factors of MDRO infection,and the prediction model was constructed accordingly.Its value for predicting MDRO infection was evaluated using receiver operating characteristic curves.Results A total of 60 patients with MDRO infection occurred in 200 patients with AECOPD,and 137 strains of MDRO were isolated.There were significant differences in acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,forced expiratory volume in one second to forced vital capacity ratio(FEV1/FVC),FEV1 percentage of predicted value(FEV1％),use of antibiotics in the past 3 months,invasive mechanical ventilation and serum interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α),interleukin(IL)-4 and IL-13 levels between the two groups(P＜0.05).The serum levels of IFN-γ,TNF-α,IL-4 and IL-13 in patients with MDRO infection were positively correlated with APACHE Ⅱ score,use of antibiotics in the past 3 months,and invasive mechanical ventilation,and negatively correlated with FEV1/FVC and FEV1％(P＜0.05).The use of antibiotics in the past 3 months,invasive mechanical ventilation and serum IFN-γ,TNF-α,IL-4 and IL-13 levels were the influencing factors of MDRO infection in AECOPD patients(P＜0.05).Delong test showed that the area under the receiver operating characteristic(ROC)curve(AUC)of Th1/Th2 cytokine model and combined model in predicting MDRO infection was better than that of clinical model(P＜0.05).Conclusion MDRO infection in AECOPD patients is closely related to the changes of Th1/Th2 cytokines.The use of antibiotics in the past 3 months,invasive mechanical ventilation and serum IFN-γ,TNF-α,IL-4 and IL-13 levels are the influencing factors of MDRO infection in AECOPD patients.The prediction model based on the above factors has a higher predictive value for MDRO infection.关键词
慢性阻塞性肺疾病急性加重期/多重耐药菌/感染/病原学/干扰素-γ、肿瘤坏死因子-α、白细胞介素-4、白细胞介素-13Key words
acute exacerbation of chronic obstructive pulmonary disease/multi-drug resistant organism/infection/etiology/interferon-γ/tumor necrosis factor-α/interleukin-4/interleukin-13引用本文复制引用
杨丽娜,张文爱,马雪梅,孟林林..慢性阻塞性肺疾病急性加重期患者多重耐药菌感染病原学分布及与Th1/Th2细胞因子含量的关系[J].临床误诊误治,2026,39(1):30-37,8.基金项目
河北省中医药管理局科研计划项目(2024459) （2024459）
