儿童抗幽门螺旋杆菌感染治疗对肠道菌群影响的研究

目的探讨抗幽门螺旋杆菌 (helicobacter pylori，Hp)感染治疗对患儿肠道菌群的影响，为预防抗生素所致肠道不良反应提供实验依据。方法收集2013年12月～2014年7月在陕西省人民医院消化内科、儿科共60例患儿，对Hp阳性患儿使用克拉霉素片、阿莫西林／克拉维酸钾片和奥美拉唑肠溶胶囊抗Hp菌治疗10天后，留取新鲜粪便标本进行肠道菌群分析。分别称取患儿治疗前后的新鲜粪便1.0 g，进行肠道菌群培养，鉴定肠道菌群的菌种，将其数量和检出率等观察指标进行统计学分析。结果肠杆菌、肠球菌、双歧杆菌、类杆菌和乳杆菌在抗Hp感染治疗前后患儿肠道的检出率均为100%。治疗后双歧杆菌、乳杆菌数量下降，差异有统计学意义(t=44.745～49.19，P<0.01)，其余肠杆菌、肠球菌、类杆菌、产气荚膜梭菌和酵母菌五类菌种治疗前后的数量差异无统计学意义(P>0.05)。治疗后患儿肠道微生物定植抗力值(B/E值)0.69±0.33，较治疗前1.18±0.44降低(t=7.715，P<0.05)。结论抗Hp感染治疗易引起患儿双歧杆菌和乳杆菌菌群紊乱，患儿肠道定植抗力降低。故抗菌药物治疗Hp感染时须注意及时补充以双歧杆菌和乳杆菌为主要成分的益生菌制剂。

Research on the Effects of Anti Helicobacter Pylori Infection on Intestinal Flora of Children

ObjectiveTo discuss the effect of anti helicobacter pylori on children’s intestinal bacteria quantity，and provide experimental basis for prevention of antibiotics which may cause intestinal adverse reactions．MethodsGathered 60 pediatric patients in the department of internal medicine and department of pediatrics in Shaanxi People's Hospital from December，2013 to July，2014．After using Clarithromycin Tablets，Amoxicillin and Clavulanate Potassium Tablets and Omeprazole Enteric-coated Capsules to Hp positive children for anti Hp therapy for 10 days，took fresh fecal specimens for intestinal flora analysis．1.0 g fresh dejection was taken before and after the treatment，and intestinal bacteria in it was cultivated and identified．The observation indexes such of Intestinal flora such as microbial numbers were then statistically analyzed．ResultsThe detection rate of enterobacter，enterococcus，bifidobacterium，bacteroides and lactobacillus in the intestinal tract of children were 100% either before or after the treatment．After treatment，the number of bifidobacterium and lactobacillus decreased．The lactobacillus’s and bifidobacterium’s P values were smaller than 0.01 before and after the treatment，which showed statistical significance，while other five’s P values were higher than 0.05，which showed no statistical significance．The B/E value was lower after treatment (P<0.05)．ConclusionThe therapy of anti H．pylori infection can cause bifidobacterium and lactobacillus flora disorder to children，and make children less resistant to colonization in intestinal tracts．Should supply the probiotic preparation which mainly consists of bifidobacterium and lactobacillus in time when using a large number of antibiotics to treat Hp infection．