咽部菌群在呼吸道感染治疗中的临床应用

Clinical Application of Pharyngeal Flora in the Treatment of Respiratory Tract Infection

目的：以健康人咽部菌群密度为参考[1]，研究呼吸道感染在治疗过程中咽部菌群密度的变化和临床症状改变的相关性分析，探讨以咽部菌群的密度变化来评估分析呼吸道感染患者的治疗和预后。方法采集102例上呼吸道感染患者（其中62例咽部菌群正常，60例咽部菌群异常）和219例下呼吸道感染患者的咽拭子进行细菌培养，研究咽部菌群密度的变化与临床症状改变的相关性。结果62例咽部菌群正常的上呼吸道感染患者其治疗与不治疗在症状改善和痊愈上差异无统计学意义（P ＞0.05），60例咽部菌群异常的上呼吸道感染患者其治疗组和不治疗组的 CPIS 评分差异有统计学意义（P ＜0.05）；对于219例下呼吸道患者（其中121例细菌性肺炎、74例重症肺炎及24例肺脓肿患者）的治疗观察，发现当咽部菌群在治疗过程中恢复正常时，与患者的临床病理改变符合率分别为92.6％，86.5％和87.5％。结论咽部菌群密度在健康人群之间保持着一定菌群种类和数量的稳定，但广谱抗生素的应用会导致咽部菌群失调；如何合理有效地治疗呼吸道感染应结合咽部菌群密度的变化来评估，这样可减少患者使用抗生素的天数，同时避免诱发耐药菌的产生和呼吸道菌群的失调。

Objective With density in healthy people pharyngeal flora of the reference[1],study the respiratory tract infection and the treatment process of the change of density and pharyngeal flora infection treatment of correlation analysis,by using the density of the pharyngeal flora changes to evaluate the treatment of patients with respiratory tract infection and progno-sis.Methods Collected 102 cases of patients with upper respiratory tract infection and 219 cases of lower respiratory tract infection in patients with pharyngeal swab for bacterial culture,study clinical symptom change with the change of pharyngeal bacteria density of correlation.Results 62 cases of upper respiratory tract infection and the treatment group patients with pharyngeal flora normal no treatment group on the symptoms improved and recovered,no statistical difference （P 〉0.05）, and 60 patients with upper respiratory tract infection and pharyngeal abnormal bacterium group the treatment group and treatment group in pharyngeal flora and CPIS score was statistically difference （P 〈0.05）.For 219 patients with lower re-spiratory tract,including 121 cases of bacterial pneumonia,74 cases of severe pneumonia,and 24 cases of patients with lung abscess treatment observation,found that when back to normal pharyngeal flora,the accuracy of clinical pathological changes were 92.6%,86.5% and 87.5%,respectively.Conclmion Pharyngeal bacteria density between healthy people maintained a certain bacteria species and the number of stable,but when respiratory infections bacteria can disorders with the application of broad-spectrum antibiotics can lead to serious result in pharyngeal dysbacteriosis should be combined with pharyngeal bacteria in respiratory anti-infection treatment density changes to evaluate the clinical treatment,can reduce the number of days with antibiotics,patients with avoid induce drug-resistant bacteria and respiratory dysbacteriosis.