Viral etiology of acute exacerbations of COPD in Hong Kong.
Viral etiology of acute exacerbations of COPD in Hong Kong.
复制标题
香港COPD急性加重的病毒病因。
作者：
Ko FW;Ip M;Chan PK;Chan MC;To KW;Ng SS;Chau SS;Tang JW;Hui DS
病毒性呼吸道感染可导致慢性阻塞性肺病（AECOPD）急性加重。然而，对亚洲AECOPD的病毒病因学知之甚少。我们的目的是研究香港AECOPD的病毒病因学。从2004年5月1日至2005年4月30日，前瞻性地招募了香港一家急性医院收治的AECOPD患者。收集鼻咽分泌物，采用聚合酶链反应（PCR）和病毒培养进行评估。出院后2 ~ 3个月进行稳定期肺活量测定。196例AECOPD患者共262次发作（平均年龄75.7±7.7岁[±SD]；男性160例）。平均FEV1为预测正常值的39.6±18.9%，FEV1/FVC比值为58.0±15.2%。58例（22.1%）病毒PCR阳性。鉴定出的病毒为甲型流感（7.3%）、冠状病毒OC43（4.6%）、鼻病毒（3.1%）、乙型流感（2.7%）和呼吸道合胞病毒（2.3%）。PCR检测的诊断率是常规病毒培养的2.7倍。FEV1≥50%、≥30 ~ 50%和< 30%预测值正常值的受试者中，PCR鉴定病毒病原学阳性的比例相似。在一项为期一年的研究期间，病毒感染似乎对随后的再入院率或死亡率没有影响，甲型流感和两种较少关注的病毒，冠状病毒OC43和鼻病毒，是香港AECOPD住院患者的常见病因。在制定与AECOPD有关的诊断和干预策略时应考虑这些因素。
Viral respiratory infections may precipitate acute exacerbations of COPD (AECOPD). However, little is known about viral etiology related to AECOPD in Asia. We aimed to study the viral etiology of AECOPD in Hong Kong. Patients admitted to an acute hospital in Hong Kong with AECOPD were recruited prospectively from May 1, 2004, to April 30, 2005. Nasopharyngeal aspirate was collected and assessed by polymerase chain reaction (PCR) and viral culture. Spirometry was performed in the stable phase at 2 to 3 months after hospital discharge. There were 262 episodes of AECOPD among 196 patients (mean age, 75.7 ± 7.7 years [± SD]; 160 men). Mean FEV1 was 39.6 ± 18.9% of predicted normal, and FEV1/FVC ratio was 58.0 ± 15.2%. Fifty-eight episodes (22.1%) yielded positive viral PCR results. The viruses identified were influenza A (7.3%), coronavirus OC43 (4.6%), rhinovirus (3.1%), influenza B (2.7%), and respiratory syncytial virus (2.3%). The diagnostic yield of viral identification by PCR was 2.7 times higher than that based on conventional viral culture. The rates of identifying a positive viral etiology by PCR were similar among the subjects with FEV1 ≥ 50%, ≥ 30 to 50%, and < 30% of predicted normal. Viral infection appeared to have no effect on subsequent readmissions or mortality rate over a study period of 1 year Influenza A and two less-attended viruses, coronavirus OC43 and rhinovirus, were the common etiologic agents in patients hospitalized with AECOPD in Hong Kong. These should be considered in developing diagnostic and intervening strategies pertaining to AECOPD.
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影响因子：
3.1
作者：
Bellau-Pujol S;Vabret A;Legrand L;Dina J;Gouarin S;Petitjean-Lecherbonnier J;Pozzetto B;Ginevra C;Freymuth F
通讯作者：
Freymuth F
影响因子：
5
作者：
Medina-Ramón, M;Zanobetti, A;Schwartz, J
通讯作者：
Schwartz, J
影响因子：
12.7
作者：
Coiras, MT;Aguilar, JC;Pérez-Breña, P
通讯作者：
Pérez-Breña, P
影响因子：
120.7
作者：
Dominici, F;Peng, RD;Samet, JM
通讯作者：
Samet, JM
DOI：
10.1164/ajrccm.162.1.9911019
发表时间：
2000-07-01
影响因子：
24.7
作者：
Greenberg, SB;Allen, M;Atmar, RL
通讯作者：
Atmar, RL