老年糖尿病患者肠道菌群的变化以及抗菌素和微生态制剂对其的影响  

The changes of intestinal flora and the effect of the antibiotics and micro-ecological agent in the elderly diabetes

作　　者：王红漫[1] 王文丽[1] 付朝晖[1] 张守华[1] 廖璞[1] 官莉[1] 陈登蓉[1] 

机构地区：[1]重庆市第三人民医院内分泌科,重庆400014

出　　处：《重庆医科大学学报》2009年第8期1101-1105,共5页Journal of Chongqing Medical University

基　　金：重庆卫生局科研项目(03-2-020)

摘　　要：目的:研究老年糖尿病(Diabetes mellitus,DM)肠道菌群的变化,以及抗菌素和微生态制剂对其的影响。方法:55名老年DM患者,以184名非DM老年患者对照。使用抗菌素者,随机分成给予微生态制剂(整肠生)和不给予组,在使用前、第5、10及15d采集大便标本,测定肠道菌群。结果:DM患者的大肠杆菌(9.53±1.76)较非DM患者(9.14±1.29)显著增多,双歧杆菌(7.02±1.85对8.31±2.17)和乳杆菌(6.75±2.86对7.51±2.36)较之明显降低(P<0.05)。抗菌素使用后拟杆菌、双歧杆菌和乳杆菌逐步下降,特别是使用至10、15d,下降达到显著性。同时给予整肠生者与未给予者比较,拟杆菌、双歧杆菌、乳杆菌有不同程度地升高。双歧菌数量与年龄呈正相关,与糖化血红蛋白呈负相关(r分别为0.358,-0.479,P<0.05)。结论:老年DM患者双歧杆菌、乳杆菌减少,大肠杆菌增加。双歧杆菌的减少与血糖控制不佳有关。抗菌素引起益生菌的减少。微生态制剂可以部分逆转抗菌素引起的肠道菌群失调。Objective：To investigate the changes of intestinal flora and the effects of antibiotics and micro-ecological agent on the intestinal flora in the elderly diabetes.Methods：Intestinal flora detection by Stool cultures,compared 55 diabetes with 184 non-diabetes.Those who need antibiotics were randomly divided into two groups：one group used micro-ecological agent（bacillus licheniformis capsules） and the other not.Their fecal were collected to detect intestinal flora before antibiotic used and at the 5th、10th and 15th day of antibiotic used.Results：Compared with non-diabetes,the quantity of Escherichia coli significantly increased（9.53±1.76 vs 9.14±1.29,P〈0.05） and the quantities of Bifidobacterium（7.02±1.85 vs 8.31±2.17,P〈0.05）and Lactobacillus（6.75±2.86 vs 7.51±2.36,P〈0.05）significantly decreased in the elderly diabetes.In antibiotic using process,the quantities of Bifidobacterum,Lactobacillum and Bacteroides decreased gradually,especially significant at the 10th and 15th day of antibiotic used.Compared with those who did not use micro-ecological agent,the quantities of Bifidobacterum,Lactobacillum and Bacteroides in those who used micro-ecological agent increased to some degrees.There was a positive correlation between Bifidobacterum＇s quantity and age（r=0.358,P〈0.05）.There was a negative correlation between Bifidobacterum＇s quantity and glycosylated hemoglobin（r=-0.479,P〈0.05）.Conclusion：There were maladjustment of intestinal flora in the elderly diabetes,the quantities of Bifidobacterium and Lactobacillus decreased and Escherichia coli＇ increased.There were relationship between poor glycemic control and the decreasing of bifidobacterum.Long-term using antibiotics made bifidobacterum and Lactobacillum＇s quantities decreased.Using micro-ecological agent could Suppress alteration of intestinal flora caused by antibiotics.

关 键 词：老年糖尿病 肠道菌群 双歧杆菌 抗菌素 微生态制剂 

分 类 号：R37[医药卫生—病原生物学]