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周文灿1 钟胜芬2.不同剂型抗生素单用与联合使用对肺炎患儿的疗效及其对肠道微生态的影响[J].中国现代医生,2021,59(27):49-53
不同剂型抗生素单用与联合使用对肺炎患儿的疗效及其对肠道微生态的影响
Effect of single and combined use of different dosage forms of antibiotics in children with pneumonia and their influence on intestinal microecology
  
DOI:
中文关键词:  抗生素  感染性肺炎  肠道菌群  D-乳酸
英文关键词:Antibiotics  Infectious pneumonia  Intestinal flora  D-lactic acid
基金项目:浙江省医药卫生科技计划项目(2019KY555)
作者单位
周文灿1 钟胜芬2 1.浙江中医药大学浙江杭州 3100532.杭州市富阳区妇幼保健院药剂科浙江杭州 311400 
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中文摘要:
      目的 探讨不同剂型抗生素单用与联合使用对感染性肺炎患儿的疗效及其对肠道微生态的影响。方法 选取2019 年8 月至2020 年8 月在我院就诊的96例新生儿感染性肺炎,按照随机抽签法分为青霉素组、头孢组、联合组各32例。青霉素组给予青霉类药物治疗,头孢组给予头孢唑肟治疗,联合组给予青霉类药物联合头孢唑肟治疗,三组均连续治疗1 周。采用荧光定量PCR检测粪便中肠道菌群数量,采用酶联免疫吸附试验检测肿瘤坏死因子-α(TNF-α)、高敏C 反应蛋白(hs-CRP)、白介素-6(IL-6)、D-乳酸、T 淋巴细胞(CD3+、CD4+、CD8+)水平,统计临床症状缓解时间和治疗效果。结果 三组治疗后肠杆菌、肠球菌、消化链球菌数量,炎症指标,D-乳酸,CD8+水平低于治疗前,双歧杆菌数量、CD3+、CD4+水平高于治疗前,差异有统计学意义(P<0.05)。联合组治疗后肠杆菌、肠球菌、消化链球菌数量,炎症指标,D-乳酸,CD8+水平分别低于青霉素组和头孢组,双歧杆菌数量、CD3+、CD4+水平均高于青霉素组和头孢组,差异有统计学意义(P<0.05)。联合组患儿发热、咳嗽、肺部啰音缓解时间短于青霉素组和头孢组,治愈率高于青霉素组和头孢组,差异有统计学意义(P<0.05)。结论 青霉素联合头孢类抗生素治疗感染性肺炎患儿效果显著,能改善其肠道微生态及T 淋巴细胞水平,抑制炎症反应,促进患儿早日康复。
英文摘要:
      Objective To investigate the effect of single and combined use of different dosage forms of antibiotics in children with infectious pneumonia and their influence on intestinal microecology.Methods A total of 96 neonates with infectious pneumonia treated in our hospital from August 2019 to August 2020 were selected and divided into the penicillin group,the cephalosporin group,and the combination group using random drawing method,with 32 patients in each group.The penicillin group were treated with penicillin,the cephalosporin group were treated with ceftizoxime,and the combination group were treated with penicillin combined with ceftizoxime.All three groups were treated for 1 week.Fluorescence quantitative PCR was used to detect the number of intestinal flora in feces.Enzyme-linked immunosorbent assay was used to detect the levels of tumor necrosis factor-α (TNF-α),high sensitivity C-reactive protein(hs-CRP),Interleukin-6 (IL-6),D-lactic acid,and T lymphocytes (CD3+,CD4+,CD8+).Clinical symptom relief time and treatment effect were analyzed.Results The numbers of Enterobacter,Enterococcus and Peptostreptococcus,and the levels of inflammation indexes,D-lactic acid and CD8+ in the three groups after treatment were lower than those before treatment.The number of bifidobacteria,and the levels of CD3+ and CD4+ in the three groups after treatment were higher than those before treatment,with statistically significant differences (P<0.05).The numbers of Enterobacter,Enterococcus and Peptostreptococcus,and the levels of inflammation indexes,D-lactic acid and CD8+after treatment in the combination group were lower than those in the penicillin group and the cephalosporin group.The numbers of bifidobacterial and the levels of CD3+ and CD4+ after treatment in the combination group were higher than those in the penicillin group and the cephalosporin group,with statistically significant differences (P<0.05).The remission time of relief of fever,cough and pulmonary rales in the combination group were shorter than those in the penicillin group and the cephalosporin group,and the cure rate in the combination group was higher than those in the penicillin group and the cephalosporin group,with statistically significant differences(P<0.05).Conclusion Penicillin combined with cephalosporin antibiotics is effective in the treatment of children with infectious pneumonia,which can improve the intestinal microecology,increase level of T lymphocyte,inhibit inflammation,and promote early recovery.
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