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目的了解临床患者使用头孢类抗菌药物后肠道菌群的改变,探讨临床患者的肠道菌群受头孢类抗菌药物的影响,从而合理使用头孢类抗菌药物。方法随机抽取消化科50例口服头孢类抗菌药物>5d的住院患者为研究对象,对照组为同期健康体检人员,共20名;均采集新鲜粪便直接涂片作革兰染色并镜检,记录每份标本中革兰阴性杆菌、革兰阳性杆菌及革兰阳性球菌所占比例。结果试验组革兰阴性杆菌、革兰阳性杆菌、革兰阳性球菌异常率分别为90.0%、82.0%和56.0%;对照组分别为15.0%、10.0%和15.0%,两组比较差异有统计学意义(P<0.01);试验组粪便菌群Ⅰ、Ⅱ、Ⅲ度失调分别占22.0%、50.0%、12.%,对照组分别占5.0%、0、0。结论头孢类抗菌药物的使用对人体肠道菌群的数量及结构影响明显,且对革兰阴性杆菌及革兰阳性杆菌的影响作用大于革兰阳性球菌。
Objective To understand the changes of intestinal microflora in patients with cephalosporins after clinical use, and to investigate the influence of cefoperazone on the intestinal flora in clinical patients so as to make rational use of cephalosporins. Methods A total of 50 inpatients with oral cephalosporins> 5 days were enrolled in this study. The control group consisted of 20 healthy physical examiners at the same period. Fresh stools were directly smeared and examined with Gram stain. Gram-negative bacilli in specimens, Gram-positive bacilli and Gram-positive cocci. Results The abnormal rates of Gram-negative bacilli, Gram-positive bacilli and Gram-positive cocci were 90.0%, 82.0% and 56.0% respectively in the test group and 15.0%, 10.0% and 15.0% in the control group, respectively (P <0.01). The fecundity of grade Ⅰ, Ⅱ and Ⅲ in the test group accounted for 22.0%, 50.0% and 12.0% respectively, while the control group accounted for 5.0% and 0,0% respectively. Conclusion The use of cephalosporin antimicrobial drugs has significant effect on the quantity and structure of human intestinal flora, and has a greater effect on gram-negative bacilli and gram-positive bacilli than gram-positive cocci.