抗幽门螺杆菌治疗对功能性消化不良患者肠道微生态的影响  

Change of intestinal microecosystem after eradicating Hp in functional dyspepsia patients

作　　者：陈渝萍[1] 梁玉环[1] 龚飞跃[1] 孙达春[1] 

机构地区：[1]暨南大学附属第三医院珠海市人民医院消化内科,广东珠海519000

出　　处：《临床荟萃》2003年第8期430-432,共3页Clinical Focus

摘　　要：目的　探讨功能性消化不良 (FD)患者抗幽门螺杆菌 (Hp)治疗后肠道微生态的变化及意义。 方法　取5 0例患者治疗前后新鲜粪便 0 .5g ,选择肠道菌群中具代表性的需氧菌 4种 ,厌氧菌 6种 ,分别进行细菌培养 ,从培养出的菌落中挑选同种菌株进行治疗前后药敏试验。结果　治疗后肠道菌群中肠杆菌、拟杆菌、双歧杆菌、消化球菌、梭菌、乳杆菌及真杆菌均较治疗前明显降低 ( P <0 .0 5 ) ;治疗后大肠埃希菌、消化链球菌、普氏梭杆菌、产气真杆菌、屎链球菌等对头孢噻吩、红霉素、四环素、庆大霉素、环丙沙星、阿莫西林、呋喃唑酮等药耐药率明显高于治疗前 (P <0 .0 5 ) ;治疗后产超广谱 β 内酰胺酶的耐药消化链球菌、产气真杆菌、普氏梭杆菌、屎链球菌等较治疗前分别增加了2 6.2 %、2 3 .4%、2 0 .0 %及 18.8%。结论　在权衡对Hp阳性FD患者是否行三联抗Hp治疗时 ,必须考虑和重视治疗后可能产生的肠道菌群失调和肠道多种耐药菌株的产生。Objective To study change of intestinal microecosystem after eradicating Helicobacter pylori(Hp) in functional dyspepsia patients. Methods Adopting fresh stool 0.5 g of 50 patients in before and after treatment, selecting 4 sorts aerobes and 6 anaerobes representative in intestines flora and cultivating them separately for antimicrobial sensitive test. Results The numbers of bacteria-Enterobacterium, Peptococcus, Fusobacterium, Bacteroides, Lactobacillus Eubacterium, Bifidobacterium after the treatment had been depressed more evidently than before, P< 0.05. The numbers of bacteria-Enteroco.Faeciumd, Fuso.Prausnitzii, Eubac.Aerofaciens, Pstrcoccu and Escherichiacoli that resisted antimicrobial agents-Cephalothin, Tetracycline, Erythromycin, Gentamicin and Ciprofloxacia after the treatment had been multiplied more evidently(P< 0.05). The numbers of bacteria-Pstrcoccus, Staph.Epidermidis, Fuso.Prausnitzii, Str.Pneumo/Virgrp and Staph.Sciuri which produced β-Lactamase after the treatment had been stepped-up about 26.2%, 23.4%, 20.0%, 18.8% separately. Conclusion To weight whether it is necessary for eradicating Hp in functional dyspepsia patients, the potential danger that results from the intestinal dysbacteriosis, diffusion and transmission of the antimicrobial resistance strains among crowds shoud be highly considered and stressed.

关 键 词：消化不良 螺杆菌 幽门肠道菌群 耐药性 

分 类 号：R574.5[医药卫生—消化系统]