儿童变应性鼻炎的细菌学研究及糠酸氟替卡松对细菌定植的影响

Bacteriological study of allergic rhinitis in children and effect of fluticasone furoate on bacterial colonization

目的研究儿童变应性鼻炎的病原微生物分布及糠酸氟替卡松对其定植的影响。方法选取48例变应性鼻炎患儿作为变应性鼻炎组,给予糠酸氟替卡松治疗,分别于治疗前后留取鼻腔分泌物进行细菌培养;另设立48例健康体检儿童为对照组进行比较。结果变应性鼻炎组送检的鼻腔分泌物标本细菌培养阳性率为39.6%,对照组细菌培养阳性率为35.4%。两组比较,鼻腔分泌物细菌检出率差异无统计学意义(P>0.05)。变应性鼻炎组19份阳性标本中有10份为金黄色葡萄球菌,对照组17份阳性标本中有7份为金黄色葡萄球菌,变应性鼻炎组与对照组金黄色葡萄球菌的检出率差异有统计学意义(P<0.05);变应性鼻炎组治疗前细菌培养阳性率为39.6%、治疗后细菌培养阳性率为41.7%,变应性鼻炎组治疗前后金黄色葡萄球菌的检出率均为18.8%,变应性鼻炎组治疗前后鼻腔分泌物细菌检出率、金黄色葡萄球菌检出率差异均无统计学意义(P>0.05)。结论金黄色葡萄球菌可能参与儿童变应性鼻炎的发病。糠酸氟替卡松是治疗儿童变应性鼻炎的有效药物,对鼻腔局部菌群无明显影响。

Objective To investigate the distribution of pathogenic microorganisms in children with allergic rhinitis(AR)and the effect of fluticasone furoate on their colonization.Methods Forty-eight children patients with allergic rhinitis were selected as the AR group and treated with fluticasone furoate.Nasal secretions were collected for conducting the bacterial culture before and after treatment.Other 48 children undergoing healthy physical examination were set as the control group for conducting the comparison.Results The positive rate of bacterial culture in nasal secretion specimens of AR group was 39.6%,which in the control group was 35.4%,the difference between the two groups had no statistical significance(P>0.05).Among 19 cases of positive sample in the AR group,10 cases were Staphylococcus aureus,while 7 cases among 17 cases of positive sample in the control group,the detection rate of Staphylococcus aureus had statistical difference between the AR group and control group(P<0.05);the positive rate of bacterial culture before treatment in the AR group was 39.6%,which after treatment was 41.7%and which of Staphylococcus aureus before and after treatment in the AR group all were 18.8%,the detection rates of nasal secretion bacteria and Staphylococcus aureus in the AR group had no statistical difference between before and after treatment(P>0.05).Conclusion Staphylococcus aureus may be involved in the pathogenesis of allergic rhinitis in children.Fluticasone furoate is an effective drug in the treatment of allergic rhinitis in children,moreover it has no significant effect on local nasal flora.