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目的采用非培养法研究成年非CF支气管扩张患者呼吸道菌群特点及与临床指标间的相关性。方法入选23例非CF支气管扩张患者(实验组,n=23)和15例健康志愿者(对照组,n=15),记录所有研究对象的一般临床指标,并收集痰液标本和支气管肺泡灌洗液标本。对痰液标本进行传统细菌培养和16S r DNA测序,对支气管肺泡灌洗液标本行16S r DNA测序。分析受试者呼吸道菌群特点及其与患者临床指标间的关系。结果痰标本焦磷酸测序检测到铜绿假单胞菌和流感嗜血杆菌的频率要高于标准培养法报告的频率。两组均显示,痰标本比BAL标本提供了更多的测序序列。细菌群落多样性与FEV1呈正的线性相关。Mantel检验显示,菌落组成的相似性和FEV1间有显著相关性,全部菌种与LCS、痰中性粒细胞数和性别间有显著相关性。结论非CF支气管扩张患者下呼吸道菌群的多样性与临床检测指标间有相关性。
Objective To investigate the characteristics of respiratory flora in adult patients with non-CF bronchiectasis using non-culture method and its correlation with clinical parameters. Methods Twenty-three non-CF bronchiectasis patients (experimental group, n = 23) and 15 healthy volunteers (control group, n = 15) were enrolled. The clinical data of all the patients were recorded and sputum samples and bronchoalveolar lavage Lotion samples. Traditional bacterial culture and 16S r DNA sequencing were performed on sputum samples, and 16S rDNA sequencing was performed on the samples of bronchoalveolar lavage fluid. The characteristics of the respiratory flora in the subjects and their relationship with the clinical parameters of the patients were analyzed. Results The frequency of Pseudomonas aeruginosa and Haemophilus influenzae detected by pyrosequencing in sputum samples was higher than that reported by standard culture method. Both groups showed that sputum specimens provided more sequencing sequences than BAL specimens. Bacterial community diversity and FEV1 showed a positive linear correlation. Mantel test showed that there was a significant correlation between the similarities of colony composition and FEV1. All the strains showed significant correlation with LCS, sputum neutrophil count and gender. Conclusion The diversity of lower respiratory tract flora in patients with non-CF bronchiectasis correlates with clinical detection indexes.