青霉素联合头孢菌素对新生儿肺炎疗效及肠道微生物环境的影响

Effect of Penicillin combined with cephalosporin on neonatal pneumonia and its influence on intestinal microbial environment

目的探讨青霉素联合头孢菌素对新生儿肺炎疗效及对肠道微生物环境的影响。方法选取徐州医科大学附属医院2018年1月至2019年12月2收治的100例患有肺炎的新生儿作为研究对象,依据随机数字表法将其分为对照组和观察组,各50例。对照组予以青霉素治疗,观察组予以青霉素联合头孢菌素治疗,治疗1周后比较两组临床疗效、安全性以及对血清白细胞(WBC)、降钙素原(PCT)和C反应蛋白(CRP)水平的影响,另外再选取同一时期徐州医科大学附属医院出生的50名健康新生儿作为参照组,比较各组间肠道微生物环境变化。结果观察组双歧杆菌、乳酸杆菌低于参照组,肠杆菌、消化链霉杆菌高于参照组,差异有统计学意义(P<0.05);观察组与对照组肠道微生物菌群含量比较,差异无统计学意义(P>0.05)。治疗后两组总有效率比较,差异无统计学意义(P>0.05)。治疗后两组患儿血清WBC、PCT、CRP水平低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论两种抗生素使用方案均能降低肺炎患儿血清炎症水平,且临床疗效与安全性相当,但联合使用抗生素可破坏患儿体内肠道微生物环境平衡。

Objective To explore the effect of Penicillin combined with cephalosporin on neonatal pneumonia and its influence on intestinal microbial environment.Methods A total of 100 cases of neonatal pneumonia in Affiliated Hospital of Xuzhou Medical University from January 2018 to December 2019 were selected as the research object.They were divided into the control group and the observation group according to the random number table method,with 50 cases in each group.The control group was treated with Penicillin,and the observation group was treated with Penicillin combined with cephalosporin.After one week of treatment,the clinical efficacy,safety and serum white blood cell(WBC),procalcitonin(PCT)and C-reactive protein(CRP)levels were compared between the two groups.In addition,50 healthy newborns born in Affiliated Hospital of Xuzhou Medical University during the same period were selected as the reference group to compare the changes of intestinal microbial environment among each group.Results Bifidobacterium and Lactobacillus in the observation group were lower than those in the reference group,while Enterobacter and Streptomyces digestive were higher than those in the reference group,and the differences were statistically significant(P<0.05);there was no significant difference in the intestinal microflora content between the observation group and the control group(P>0.05).There was no significant difference in the total effective rate between the two groups after treatment(P>0.05).After treatment,the serum WBC,PCT,and CRP levels of the two groups were lower than those before treatment,and the observation group was lower than the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Both of two antibiotic regimens can reduce the level of serum inflammation in children with pneumonia,and the clinical efficacy and safety are similar,but the combined use of antibiotics can destroy the balance of intestinal microbial environment in children.