entially pat hogenic microorganisms,PPM)。因此,急性加重时分离出这些微生物并不能说明它们一定是引起本次加重的致病原。
7 意义和展望
近年来, 随着有关COPD研究的不断开展,COPD的发病机制、病理生理、治疗等方面的研究有了较大的进展,但关于感染和COPD的关系仍有许多尚未解决的问题。越来越多的学者认为细菌感染在COPD急性加重中起主要作用,但目前仍需要完善的检测技术以明确疑似感染引起的“原因不明的急性加重”的病因。另一个需要进一步研究的问题是COPD稳定期呼吸道细菌定植和感染对疾病进程的影响,细菌在稳定期的定植和炎症反应的背景不是很清楚,这些都需要我们今后开展更多的随机化研究。
【参考文献】
[1] 徐 凌,蔡柏蔷.浅析2006年慢性阻塞性肺疾病全球倡议.国际呼吸杂志,2007,27(3):161.
[2] 中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2007年修订版).中华结核和呼吸杂志,2007,30(1):7.
[3] Ball P. Epidemiology and treatments of chronic bronchitis and its exacerbations.Chest,1995,108(2):43~52.
[4] Mons óE,Ruiz J,Rosell A,et al.Bacterial infection in chronic obstructive pulmonary disease. A study of stable and exacerbated outpatients using the protected specimen brush. Am J Respir Crit Care Med,1995,152(4):1 316~1 320.
[5] Soler N,Torres A,Ewig S,et al.Bronchial microbial patterns in severe exacerbation of chronic obstructive pulmonary disease(COPD) requiring mechanical ventilation.Am J Respir Crit Care Med,1998,157(5):1 498~1 505.
[6] Hunter MH,King DE.COPD:Management of AcuteExacerbations and Chronic Stable Disease.Am Fam Physician,2001,64:603~612.
[7] Miravitlles M,Espinosa C,Fernandez-Laso E,et al.Relationship between bacterial flora in sputum and functional impairment inpatients with acute exacerbations of COPD.Chest,1999,116(1):40~46.
[8] Eller J,Ede A,Schaberg T,et al.Infective exacerbations ofchronic bronchitis.Relation between bacterial etiology and lung function.Chest,1998,113(6):1 542~1 548.
[9] Miravitlles M. Exacerbations of chronic obstructive pulmonary disease :when are bacteria important.Eur Respir J,2002,20:9~19.
[10] Connors AF,Dawson NV,Thomas C,et al.Outcomes following acute exacerbation of severe chronic obstructive pulmonarydisease. Am J Respir Crit C are Med,1996,154(4):959~967.
[11] Bandi V,Apicella MA,Mason E,et al.NontypeableHaemophilus influenzae in the lowe
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