支气管肺炎患儿治疗过程中肠道双歧杆菌和大肠杆菌的变化

Variation of intestinal microflora in children with pneumonia during treatment

目的研究支气管肺炎患儿治疗过程中肠道双歧杆菌和大肠杆菌的变化,并与同年龄段同性别的健康儿童进行比较。为采用微生态制剂防治抗生素引起的肠道菌群变化提供数据参考。方法收集30例支气管肺炎患儿及30例健康儿童的粪便标本,提取目标细菌 DNA,测量和比较肺炎患儿和健康儿童标本细菌的 DNA-D(260)值;应用细菌的16S rRNA/DNA 序列设计双歧杆菌和大肠杆菌的引物,行常规 PCR 完成细菌定性;然后取标准定量的两种细菌 DNA 经一序列稀释后行荧光定量 PCR,并制成标准曲线;将待测标本同样行荧光定量 PCR 后与标准曲线进行对比,得出标本中两种细菌含量。结果支气管肺炎患儿治疗后的肠道菌群与健康儿童比较发生了明显的变化(F=50.78,P<0.01);肠道中双歧杆菌数量(拷贝数/克湿便)的对数值,患儿治疗第1天为7.10±0.59,治疗第3天为6.03±0.51,治疗第7天为6.34±0.52,健康儿童为9.48±0.44,经统计学处理差异有统计学意义(P<0.01)。而大肠杆菌数量的对数值,患儿治疗第1天为6.74±0.38,治疗第3天为6.13±0.35,治疗第7天为7.08±0.40,健康儿童为7.54±0.45,经统计学处理差异有统计学意义(P<0.01)。结论支气管肺炎患儿治疗过程中肠道菌群比健康组低。因此在治疗支气管肺炎患儿时采用微生态制剂,调整细菌比例,改善肠道内环境,使肠道内益生菌的数量尽快恢复正常。[临床儿科杂志,2008,26(10):853-857]

Objectives To study the variation of intestinal microflora in children with pneumonia during treatment, and compare with the same age healthy children, for providing basic information on using microeeologic products to prevent and treat antibiotic induced secondary intestinal microflora imbalance. Methods Feces were collected from 30 children with pneumonia during treatment and 30 healthy children. The bacteria DNA was extracted, detected, and compared between pneumonia and health children by DNA-D（260） . The primes of Bifidobacteria and Escherichia colt were designed by bacterial 16S rRNA/DNA sequence. The bacteria were detected qualitatively by general PCR. Then, the standard curve of fluorescent quantification PCR was made by using a series of accurately diluted bacteria DNA. The samples were measured by PCR and the results were checked against the standard curve to obtain the quantitative data. Results Compared with healthy children, the amount of Bifidobacteria and Escherichia colt were decreased in pneumonia patients （P 〈 0.01 ）. The logarithmic absolute values of Bifidobacteria on the first day, third day, seven day after treatment in pneumonia patients and in control were 7.10 ± 0.59, 6.03 ±0.51, 6.34 ± 0.52, 9.48 ± 0.44, respectively （P 〈 0.01）. The logarithmic absolute value of Escherichia colt on the first day, third day, seven day after treatment in pneumonia patients and in control were 6.74 ± 0.38, 6.13 ± 0.35, 7.08 ± 0.40, 7.54 ± 0.45, respectively （P 〈 0.01 ）. Conclusions The amounts of Bifidobacteria and Escherichia colt in pneumonia patients were lower than in healthy children. During pneumonia treatment, the microecologic products should be used to adjust intestinal microflora to improve intestinal condition as soon as possible.