IgA肾病与非肾炎患者慢性扁桃体炎细菌谱及药敏对比分析

【目的】检测IgA肾病（IgAN）慢性扁桃体炎与非肾炎慢性扁桃体炎患者细菌谱及药物敏感情况,为临床治疗及分析IgAN发病机制提供依据。【方法】①对45例IgAN病人（A组）及45例非肾炎慢性扁桃体炎病人（B组）实施扁桃体摘除术;②无菌收集患者扁桃体,对两组病人扁桃体隐窝内细菌进行分离鉴定及药物敏感试验。【结果】①细菌检出率：两组每份标本均有细菌,细菌检出率均为100％,两组相比较无统计学差异（P〉0．05）。②细菌种类：A组分离出各种细菌139株,B组138株,两组均检出链球菌、奈瑟菌、副流感嗜血杆菌、葡萄球菌、变形杆菌、肺炎链球菌,两组患者的细菌种类相比较无统计学差异（P均〉0．05）,两组患者均有甲型链球菌,且甲型链球菌在分离的细菌中最多。④细菌药敏试验结果：两组对青霉素、氯霉素、大环内酯类、第1代及第2代头孢菌素、第3代及第4代头孢菌素、庆大霉素、丁胺卡那霉素、氟哌酸环丙沙星、利福平、万古霉素的敏感率无统计学差异（P均〉0．05）。【结论】两组患者均有甲型链球菌,且甲型链球菌在分离的细菌中最多。两组患者的细菌谱和药敏结果无统计学差异。推测IgAN发病机制可能与扁桃体免疫异常有关。

Comparative Study of Bacterial Spectrum and Drug Sensitivity Between Chronic Tonsillitis Patients with IgA Nephropathy and Without Nephritis

[Objective]To detect the bacterial spectrum and drug sensitivity in chronic tonsillitis patients with IgA nephropathy （IgAN） and without nephritis in order to provide the evidence for clinical therapy and pathogenesis of IgAN. [Methods] A total of 45 patients with IgAN（group A） and 45 chronic tonsillitis patients without nephritis（group B） underwent tonsillectomy. The tonsil tissues of patients were collected under sterile condition. The bacteria in tonsil crypt of patients in two groups were isolated and identified for drug sensitivity test. [Results] There were bacteria in each specimen in both groups. The bacterial detection rate was 100 %, but there was no significant difference between two groups（ P 〉0. 05）. The 139 strains of bacteria in group A and 138 strains of bacteria in group B were isolated. Streptococcus, Neisseria, Haemophilus parainfluenzae, Staphylococcus, Bacillus proteus and Streptococcus pneumoniae were detected in two groups, but there was no significant difference in the types of bacteria between two groups（all P〉 0.05）. Alpha streptococcus in two groups was detected and the most common. The drug sensitivity test showed that there were no significant differences in the sensitivity to penicillin, chloramphenicol, macrolides, cephalosporin, gentamicin, amikacin sulphate, norfloxacin, ciprofloxacin, rifampicin and vancomycin between two groups（all P 〉 0.05 ）. [Conclusion] Alpha streptococcus in both two groups can be detected and is the most common. There is no significant difference in bacterial spectrum and drug sensitivity between two groups. It indicates that the immunologic abnormality of tonsils may be related to the pathogenesis of IgAN.