抗幽门螺旋杆菌感染治疗对儿童肠道菌群的影响分析

Impact analysis of Helicobacter pylori infection therapy to intestinal flora of children

目的研究抗幽门螺旋杆菌感染治疗对儿童肠道菌群的影响分析。方法按标准选取2015年1月~2016年10月在我院就诊患儿104例,所有患者入院后13C呼气试验,其中59例患者经检测后确定Hp感染阳性,45例患者Hp感染阴性,取所有患儿新鲜粪便2.0g,用10倍稀释法分别稀释至10^(-1)、10^(-3)、10^(-5)、10^(-7)进行厌氧和需氧培养,选择培养肠道中的典型菌落,如肠球菌、肠杆菌、酵母菌、双歧杆菌、乳杆菌、产气荚膜梭菌、类杆菌进行培养。培养检测后所有患者采取阿莫西林+克拉霉素+奥美拉唑联合用药,治疗1周后,所有患者再次进行粪便菌群培养。结果 Hp阳性组和Hp阴性组组间肠道菌落数量及B/E比较,差异无统计学意义(P>0.05)。与治疗前比较,Hp阳性患儿治疗后酵母菌及产气荚膜梭菌检出率比较,差异有统计学意义(P<0.05);而其余菌落无统计学意义。与治疗前比较,Hp阳性患儿治疗后肠道菌菌落数量均有较大变化,双歧杆菌及肠杆菌较原来增多,其余皆减少,差异有统计学意义(P<0.05),B/E值治疗后较治疗前减小,差异具有统计学意义(P<0.05)。结论抗Hp感染影响儿童肠道菌群,减少体内有益的厌氧菌数量,增加原本体内不占优势的需氧杆菌,且更容易受到病原菌的侵袭。

Objective To study the impact of Helicobacter pylori infection therapy to intestinal flora of children. Methods 104 children cured in our hospital from January 2015 to October 2016 were standardly selected.Ail the patients were given 13C breath test after admission.There were 59 cases of positive Hp infection,and 45 cases of negative Hp infection.Taking fresh stool 2.0g,and they were diluted to 10^-1,10^-3,10^-5,10^-7 to carry on anaerobic and aerobic culture by 10 fold dilution method.Typical colonies in the intestine were selected to culture,cuch as Enterococcus faecalis,enterobac ter,yeast,Bifidobacterium,Lactobacillus,Clostridium perfringens,Bacteroides.After culture test,all the patients were treated with combination of amoxicillin,clarithromycin and omeprazole.After 1 weeks of treatment,all the patients were followed up by fecal bacteria culture. Results There was no significant difference between Hp positive group and Hp negative group in intestinal colony number and B/E（P 〉 0.05）.Compared with before treatment,there was significant difference in the detection rate of yeast and Clostridium perfringens in Hp positive children （P 〈 0.05）.There Was no significant difference in other colonies.Compared with before treatment,there were significant changes in the number of intestinal bacterial colonies in Hp positive children.Bifidobacteria and Enterobacteriaceae were increased,while others were reduced.The difference was statistically significant （P 〈 0.05）.B/E value after treatment decreased than before treatment,the difference was statistically significant （P 〈 0.05）. Conclusion Anti Hp infection will impact the intestinal flora in children,reduce the number of beneficial bacteria in the body,and increase the original body does not take advantage of aerobic bacteria.It is more susceptible to invasion by pathogens.