幽门螺旋杆菌抗感染治疗对肠道菌群的影响分析

Analysis of the effect of anti-infection therapy of Helicobacter pylori on intestinal flora

目的通过对幽门螺杆菌(HP)感染患者四联方法治疗后,对肠道菌群的影响分析。方法选择2018年到该院消化内科就诊的50例HP感染患者,均采用克拉霉素+阿莫西林/克拉维酸钾+奥美拉唑+枸橼酸铋钾四种药联合治疗HP感染,收集治疗前及治疗10 d后的新鲜粪便进行肠道菌群分析,取1.0 g用10倍稀释法分别稀释至10-1、10-3、10-5进行厌氧和需氧培养,选择培养肠道中的典型菌落,鉴定需氧菌和厌氧菌的菌种,菌落数量和检出率做统计学分析,对常见细菌进行药敏试验,比较治疗前后对常用抗菌药物的耐药性。结果治疗后培养出的葡萄球菌、肠球菌、梭菌菌落数量较治疗前增加,乳酸杆菌、双歧杆菌、肠杆菌菌落数量较治疗前降低,差异有统计学意义(P<0.01);治疗前后酵母菌、类杆菌菌落数量比较,差异无统计学意义(P>0.05)。治疗后超广谱内酰氨酶阳性的常见菌种对常见抗菌药物耐药率均较治疗前显著提升,差异有统计学意义(P<0.05)。结论通过联合用药对幽门螺杆菌抗感染治疗,可造成肠道菌群失调,增加耐药菌株。

Objective To analyze the effect of four-way therapy on intestinal flora of patients with Helicobacter pylori(HP)infection.Methods In 2018,selected 50 patients with HP infection from the Department of Gastroenterology Pidu District Chinese Medicine Hospital,all patients were treated with clarithromycin+Amoxicillin/clavulanate potassium+ome+Colloidal Bismuth Subcitrate combination of four drugs in the treatment of HP.Fresh feces were collected before and 10 days after treatment for intestinal microflora analysis,1.0 g was diluted to 10-1,10-3,10-5 by 10 times dilution method for anaerobic and aerobic culture.Selective culture of typical colonies in the intestinal tract,identification of aerobic bacteria and anaerobic bacteria,the number and detection rate of colonies were statistically analyzed,the drug sensitivity test of common bacteria was carried out to compare the drug resistance of common antibiotics before and after treatment.Results The number of staphylococcus,enterococcus and Clostridium colony cultured after treatment increased compared with that before treatment,The number of Lactobacillus,Bifidobacterium and Enterobacter colony is lower than that before treatment,the difference was statistically significant(P<0.01);there was no significant difference in the number of yeast and Bacteroid colonies before and after treatment(P>0.05).After treatment,the resistance rate of common strains with ultra-broad-spectrum lactamase positive to common antibiotics was significantly higher than that before treatment,the difference was statistically significant(P<0.05).Conclusion Combined treatment of Helicobacter pylori infection may cause intestinal flora disorders and increase drug-resistant strains.