社区慢性阻塞性肺病患者抗生素使用状况与肠道菌群特征及耐药的关联研究

慢性阻塞性肺病（COPD）是我国居民主要的慢性病类型，患者具有抗生素使用普遍及耐药高发的特征，既往基于医疗信息系统的COPD患者抗生素使用分析，因缺少相关人群特征而无法对患者抗生素使用的相关因素及长期健康效应进行系统探讨。此外，该群体抗生素的普遍使用可导致细菌耐药流行及相关健康效应。而既往肠道菌群特征分析多在近期内未服用过抗生素的群体中开展，对不同抗生素使用状况下的肠道菌群改变以及菌群耐药特征缺乏系统研究。本研究着眼于社区COPD病例，采用队列研究设计，依托区域医疗卫生信息平台，全面分析社区COPD患者自队列基线调查以来的抗生素使用状况，探讨抗生素使用的相关特征及其健康效应；并采用重复调查设计分析不同抗生素使用特征人群在不同用药时间点的抗生素暴露健康风险、肠道菌群构成及耐药基因检出状况，从而识别耐药高风险人群，以促进该群体抗生素合理使用。

Chronic obstructive pulmonary disease (COPD) was one of the main types of chronic disease in China. Patients with COPD had a common antibiotic usage and experienced a high prevalence of antibiotic resistance. The former analyses on antibiotic usage in COPD patients were mainly based on electronic medical records and could not systematically assess the related factors as well as potential health outcomes of antibiotic usage, which might due to the lack of relevant characteristics. In addition, the common antibiotic usage in COPD patients might result in the high occurrence of antibiotic resistance and related health effects. Most analyses on gut microbiota were sampled from population that had not taken antibiotics for several months. There was no systematic investigation on the variety of gut microbiota and the characteristics of antibiotic resistance in patients with different antibiotic usage conditions. This study aims to comprehensively analyze the antibiotic usage status, its relevant factors, and potential health effects in community COPD patients by using the cohort study design and integrating the baseline characteristics and information from the regional medical and health information platform. Variety of urinary antibiotics health risk assessments, composition of gut microbiota, as well as the detection of antibiotic resistant genes will also be investigated by using a repeating sampling methods at different time points in COPD patients with distinctive antibiotic usage, so as to identify the high-risk population of antibiotic resistance and promote the rational use of antibiotics in this population.