摘要
目的探讨不同抗生素对肺炎患者肠道菌群的影响。方法选取吉林市人民医院2020年7月至2021年9月收治的300例肺炎患者作为研究对象,采用随机数字表法将其分为对照组、头孢呋辛钠组、左氧氟沙星组、头孢哌酮组和亚胺培南组,每组60例。所有患者均应用肠道菌群培养联合基质辅助激光解吸电离飞行时间质谱检测肠道菌群。对照组在未应用抗生素前检测肠道菌群,其余四组在应用抗生素7 d后检测肠道菌群。比较五组患者的肠道细菌、真菌、益生菌总量及比例的变化和菌群多样性。结果对照组、亚胺培南组、头孢哌酮组、左氧氟沙星组及头孢呋辛钠组的细菌总数和益生菌总数依次减少,差异有统计学意义(P<0.05);头孢哌酮组及亚胺培南组球菌/杆菌高于对照组和左氧氟沙星组,差异有统计学意义(P<0.05)。头孢哌酮组和亚胺培南组的真菌数量高于对照组、头孢呋辛钠组及左氧氟沙星组,差异有统计学意义(P<0.05)。亚胺培南组和头孢哌酮组的菌属数和菌种数低于对照组、头孢呋辛钠组和左氧氟沙星组,差异有统计学意义(P<0.05)。结论应用抗生素级别越高、抗菌谱越广,肠道菌群种类及数量越少,真菌数量越多,肠道菌群失调越严重。
Objective To investigate the effects of different antibiotics on gut microecology in patients with pneumonia.Methods A total of 300 patients with pneumonia admitted to Jilin City People's Hospital from July 2020 to September 2021 were selected as the research objects.They were divided into control group,Cefuroxime Sodium group,Levofloxacin group,Cefoperazone group and Imipenem group by random number table method,with 60 cases in each group.Intestinal microbiota culture combined with matrix-assisted laser desorption ionization time-of-flight mass spectrometry was used to detect intestinal microbiota in all patients.The intestinal flora of the control group was detected before antibiotic administration,and the intestinal flora of the other four groups was detected 7 d after antibiotic administration.The changes of the total amount and proportion of intestinal bacteria,fungi and probiotics and the diversity of intestinal flora were compared among the five groups.Results The total number of bacteria and probiotics in control group,Imipenem group,Cefoperazone group,Levofloxacin group and Cefuroxime Sodium group decreased successively,and the differences were statistically significant(P<0.05).The Cocci/Bacilli of Cefoperazone group and Imipenem group were higher than those of control group and Levofloxacin group,and the differences were statistically significant(P<0.05).The number of fungi in Cefoperazone group and Imipenem group were higher than those in control group,Cefuroxime Sodium group and Levofloxacin group,and the differences were statistically significant(P<0.05).The number of bacteria genera and species in Imipenem group and Cefoperazone group were lower than those in control group,Cefuroxime Sodium group and Levofloxacin group,and the differences were statistically significant(P<0.05).Conclusion The higher the level of antibiotics used,the wider the antibacterial spectrum,the less the species and number of gut microbiota,the more the number of fungi,the more serious the imbalance of gut microbiota.
作者
李明蔚
于苗
蔡玉琰
谭寅凤
孙菲
赵艳金
许潆月
刘鹏
LI Mingwei;YU Miao;CAI Yuyan;TAN Yinfeng;SUN Fei;ZHAO Yanjin;XU Yingyue;LIU Peng(Department of Clinical Nutrition and Geriatrics,Jilin People's Hospital,Jilin Province,Jilin 132000,China;Department of Critical Medicine,Jilin People's Hospital,Jilin Province,Jilin 132000,China;Department of Pharmacy,Jilin People's Hospital,Jilin Province,Jilin 132000,China)
出处
《中国当代医药》
CAS
2022年第32期49-53,共5页
China Modern Medicine
基金
吉林省吉林市医疗卫生指导性计划项目(20200404099)。
