摘要
普通感冒与慢性阻塞性肺病(COPD)的加重有关。然而,普通感冒病毒(人鼻病毒)在COPD加重时产生症状和低气道炎症的作用尚不清楚。33例中度至重度COPD患者在基线时观察,当时记录了前一年胸部感染的数量,在COPD加重时观察到急性。在加重发作后48 h及基线时间内,取鼻吸液和诱导痰进行鼻病毒逆转录聚合酶链反应(RT-PCR)分析和测定细胞因子水平。将症状记录在日记卡上,并测量一秒钟用力呼气量(FEV1)和用力肺活量(FVC)。在加重时,平均FEV1和FVC较基线显著下降(p<0.001)。43例急性加重中有10例与诱导痰中发现的鼻病毒感染有关。其中四个国家的鼻咽样本未检测到鼻病毒。所有基线样本均为鼻病毒阴性。同时出现的鼻分泌物/鼻塞增加(43例加重中的26例)和痰液增加(29例加重)与鼻病毒的存在密切相关(优势比6.15; p=0.036). Total symptom scores were greater for rhinovirus as compared to nonrhinovirus exacerbations (p=0.039). Median baseline sputum interleukin-6 levels rose from 90.2 to 140.3 pg x mL(-1) at exacerbation (p=0.005); the change was greater in the presence of rhinovirus infection (p=0.008). Rhinovirus infection can be detected at chronic obstructive pulmonary disease exacerbation. This is associated with elevation of lower airway interleukin-6 levels, which may mediate lower airway symptom expression during chronic obstructive pulmonary disease exacerbations.