共查询到19条相似文献,搜索用时 109 毫秒
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关岚周衡王聪刘志伟赵斌 《中华急诊医学杂志》2022,(4):514-519
目的探讨脓毒症患者发病过程中肠道菌群多样性和结构变化情况。方法对2015年11月至2016年3月期间于北京市多家三甲医院急诊科就诊并符合Sepsis3.0诊断标准的脓毒症患者25例和同时期30例非脓毒症患者的粪便样本进行检测,利用16S rRNA(16S ribosomal RNA)测序技术对肠道菌群进行测序,使用Uparse、Qiime、R及LEfSe软件等分析菌群多样性及其结构变化。结果脓毒症组和非脓毒症组患者在性别、年龄以及慢性基础疾病方面比较差异无统计学意义。两组在肠道菌群多样性方面比较差异无统计学意义(P>0.05)。两组在肠道菌群结构方面比较,差异有统计学意义(P<0.05),即脓毒症组患者肠道菌群中Negativicutes纲、Selenomonadales目、Veillonellaceae科、Lachnospiraceae科、Faecalibacterium属、Hafnia属、Lachnoclostridium属、Blautia属及Ruminococcus种的菌群丰度明显降低;而Bacilli纲、Coriobacteriia纲、Lactobacillales目、Coriobacteriales目、Clostridiaceae科、Coriobacteriaceae科、Clostridium_sensu_stricto属、Collinsella属及Collinsella_aerofaciens种的菌群丰度明显增加。结论脓毒症组与非脓毒症组患者相比较,肠道菌群多样性无改变;而脓毒症组的患者存在肠道菌群组成结构改变。 相似文献
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目的 探究重症监护室(ICU)肺部感染患者的肠道菌群特征,为肺部感染的危重症患者微生态靶向治疗提供借鉴。方法 收集2021年3-9月入住重庆高新区人民医院ICU的肺部感染患者粪便样本78例,ICU非肺部感染患者粪便样本22例,健康人群的粪便样本40例,采用16S rRNA测序技术对粪便菌群进行检测鉴定,通过生物信息学方法比较并分析ICU肺部感染患者肠道菌群结构特征。结果 ICU肺部感染患者的肠道微生物与健康人群相比,alpha多样性显著降低。ICU肺部感染患者肠道菌群以厚壁菌门、拟杆菌门、普雷沃菌属和拟杆菌属为主。处于极度失调(单一菌群丰度>50%)的ICU肺部感染患者的肠道菌群主要富集了普雷沃菌属、拟杆菌属、肠球菌和埃希菌等细菌。LEfSe分析提示,疣微菌科是ICU肺部感染患者肠道菌群中的标志性微生物。ICU肺部感染患者与健康人群相比,糖类和氨基酸代谢通路有所降低。另外,患者年龄结构、体质量指数、急性生理与慢性健康评分系统Ⅱ评分和住院时间与部分肠道菌群存在紧密联系。结论 ICU肺部感染患者与健康人群相比,肠道菌群多样性显著降低。ICU肺部感染患者中肠道菌群极度失调者,可能由于感... 相似文献
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目的 通过16S rDNA检测技术探讨慢传输型便秘(STC)患者肠道菌群特点以及肠道菌群移植(FMT)的作用。方法 选取30例STC患者作为STC组,给予2个疗程的规范化FMT治疗;选取同期20例健康成年人作为对照组。采用粪便16S rDNA测序技术对STC组和对照组肠道菌群进行比较,并对STC患者实施FMT前后的肠道菌群进行比较。结果 与对照组相比,STC组肠道菌群多样性降低,厚壁菌门相对丰度降低,而变形菌门和梭杆菌门相对丰度升高,差异均有统计学意义(P<0.05)。经FMT治疗后,功能性便秘患者菌群多样性升高,差异有统计学意义(P<0.05);在门水平上,STC患者实施FMT后拟杆菌门和梭状菌门相对丰度降低,而厚壁菌门和变形菌门相对丰度升高,差异有统计学意义(P<0.05)。STC组胃肠生活质量评分(GIQLI)、Wexner便秘评分均较治疗前下降,差异有统计学意义(P<0.05)。STC组抑郁自评量表(SDS)评分、焦虑自评量表(SAS)评分、匹兹堡睡眠质量评分(PSQI)均较治疗前下降,差异有统计学意义(P<0.05)。结论 STC患者肠道菌群易发... 相似文献
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目的 从分子生物学角度初步探究儿童患者不同阑尾炎病理类型的阑尾内容物菌群结构特征,为全面认识儿童阑尾炎病原菌提供新的视角。方法 依据手术组织病理分组,将收治的儿童阑尾炎患者分为单纯性阑尾炎组(n=6)和化脓性阑尾炎组(n=6),收集阑尾内容物DNA,对细菌rRNA基因序列V3-V4高变区扩增,用Illumina Nova测序,聚类分析两组菌群结构、丰度和多样性。结果 两组间Alpha多样性分析,差异有统计学意义(P <0.05),菌群丰度比较R=0.34,差异有统计学意义(P <0.05)。两组阑尾组织内容物在目、科、属、种水平有差异。在属水平单纯性阑尾炎组粪杆菌属、直肠真杆菌属居多,化脓性阑尾炎组嗜胆菌属居多。结论 通过对儿童阑尾炎患者不同病理类型阑尾内容物菌群的多样性分析,可发现单纯性阑尾炎和化脓性阑尾炎在菌群丰度和多样性上存在差异,为临床阑尾炎组织病原学研究提供新的思路。 相似文献
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目的 利用重复共有序列(ERIC)和变性梯度凝胶电泳(DGGE)两种分子指纹图谱技术对2型糖尿病患者肠道菌群结构特征分析,探讨2型糖尿病与肠道菌群的相关性及对两种方法的评价。方法 收集8例健康人和7例2型糖尿病患者粪便样本,提取粪便菌群总DNA,采用ERIC-PCR和DGGE-PCR分子指纹图谱技术对两组人群肠道菌群结构分析,比较其多样性、相似性等生态学特征。结果 与健康对照组比较,2型糖尿病患者肠道菌群图谱条带和Shannon-Wiener多样性指数降低,但无统计学意义; 组内相似性降低差异有统计学意义(P<0.05),菌群结构发生变化; 两种指纹图谱技术均能直观反映肠道菌群结构特征,ERIC方法简便,反映菌群多样性良好,但是实验影响因素较多,不可切胶测序; DGGE能较好反映菌群多样性、相似性等生态学特征,而且可选择条带切胶测序。结论 2型糖尿病患者肠道菌群组成结构发生改变,糖尿病的发生与肠道菌群有一定相关性; ERIC和DGGE是研究肠道菌群分辨效率高、重复性好的指纹图谱技术,DGGE并可进行切胶测序比对鉴定细菌,二者可结合使用。 相似文献
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Delirium in Newly Admitted Elderly Patients: A Prospective Study 总被引:1,自引:0,他引:1
JITAPUNKUL S; PILLAY I; EBRAHIM S 《QJM : monthly journal of the Association of Physicians》1992,83(1):307-314
The prevalence, associated conditions and outcome of deliriumwere studied in a consecutive series of 184 patients admittedwith acute illness to a department of health care of the elderly.Forty of these elderly subjects (22 per cent) met Diagnosticand Statistical Manual version 3 (revised) criteria for delirium.Screening for delirious patients using the abbreviated mentaltest on admission gave a high sensitivity (92 per cent). Theconditions most commonly associated with delirium were infectionand stroke. Onset of acute illness of less than 15 days, a reportedhistory of dementia or recent confusion, and presence of a definitesite of infection were much more likely in those with delirium.Serial use of the abbreviated mental test was a sensitive meansof distinguishing delirious from other patients and may be usefulin both the clinical and research setting. Delirious patientshad more serious pre-existing diseases than non-delirious patients.They had a higher number of admissions during the 2 years priorto the index admission, a higher mortality rate and a higherrate of transfer to long-stay care than other patients, butno difference in duration of admission. All acutely ill elderlypeople should undergo an abbreviated mental test on admission,and if abnormal, this should be repeated as it will aid detectionof delirium. 相似文献
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Alec B. O'Connor MD MPH Frank L. Zwemer MD MBA Daniel P. Hays PharmD Changyong Feng PhD 《Academic emergency medicine》2009,16(6):477-487
Objectives: Pain management continues to be suboptimal in emergency departments (EDs). Several studies have documented failures in the processes of care, such as whether opioid analgesics were given. The objectives of this study were to measure the outcomes following administration of intravenous (IV) opioids and to identify clinical factors that may predict poor analgesic outcomes in these patients. Methods: In this prospective cohort study, emergency patients were enrolled if they were prescribed IV morphine or hydromorphone (the most commonly used IV opioids in the study hospital) as their initial analgesic. Patients were surveyed at the time of opioid administration and 1 to 2 hours after the initial opioid dosage. They scored their pain using a verbal 0–10 pain scale. The following binary analgesic variables were primarily used to identify patients with poor analgesic outcomes: 1) a pain score reduction of less than 50%, 2) a postanalgesic pain score of 7 or greater (using the 0–10 numeric rating scale), and 3) the development of opioid-related side effects. Logistic regression analyses were used to study the effects of demographic, clinical, and treatment covariates on the outcome variables. Results: A total of 2,414 were approached for enrollment, of whom 1,312 were ineligible (658 were identified more than 2 hours after IV opioid was administered and 341 received another analgesic before or with the IV opioid) and 369 declined to consent. A total of 691 patients with a median baseline pain score of 9 were included in the final analyses. Following treatment, 57% of the cohort failed to achieve a 50% pain score reduction, 36% had a pain score of 7 or greater, 48% wanted additional analgesics, and 23% developed opioid-related side effects. In the logistic regression analyses, the factors associated with poor analgesia (both <50% pain score reduction and postanalgesic pain score of ≥7) were the use of long-acting opioids at home, administration of additional analgesics, provider concern for drug-seeking behavior, and older age. An initial pain score of 10 was also strongly associated with a postanalgesic pain score of ≥7. African American patients who were not taking opioids at home were less likely to achieve a 50% pain score reduction than other patients, despite receiving similar initial and total equianalgesic dosages. None of the variables we assessed were significantly associated with the development of opioid-related side effects. Conclusions: Poor analgesic outcomes were common in this cohort of ED patients prescribed IV opioids. Patients taking long-acting opioids, those thought to be drug-seeking, older patients, those with an initial pain score of 10, and possibly African American patients are at especially high risk of poor analgesia following IV opioid administration. 相似文献
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A Prospective Study of Hepatic Tuberculosis in 41 Black Patients 总被引:1,自引:0,他引:1
MAHARAJ BREMINAND; LEARY WILLIAM P.; PUDIFIN DENNIS J. 《QJM : monthly journal of the Association of Physicians》1987,63(3):517-522
Forty-one black patients aged 21 to 75 years with hepatic tuberculosisdiagnosed at liver biopsy were studied prospectively. The livervaried in size and consistency and was tender in 44 per centof patients. Abdominal symploms, weight loss, pyrexia, hepatomegaly,splenomegaly and anaemia were absent in 54, 39, 37, 5, 68 and27 per cent of patients respectively. Twenty-two per cent ofchest radiographs were normal. Liver function tests were oflittle diagnostic value and hepatic imaging techniques oftengave normal results. Acid-fast bacilli, caseation and coexistentliver disease were detected in 59, 51 and 37 per cent of patientsrespectively. Since there was no consistent clinical pattern a high indexof suspicion is necessary if this disease is to be detectedin communities in which tuberculosis is endemic. In patientswith unexplained hepatomegaly or hepatosplenomegaly or pyrexiaof unknown origin liver biopsy provides the only means of makingthis diagnosis. 相似文献