不同抗生素治疗方案对婴幼儿肠道微生态和外周血T淋巴细胞亚群的影响

钟胜芬; 周文灿; 倪妙君; 朱雨晴; 闻超; 金姬; 杨雨

doi:10.16766/j.cnki.issn.1674-4152.001963

不同抗生素治疗方案对婴幼儿肠道微生态和外周血T淋巴细胞亚群的影响

doi: 10.16766/j.cnki.issn.1674-4152.001963

1.
杭州市富阳区妇幼保健院药剂科, 浙江杭州 311400
2.
杭州市富阳区妇幼保健院儿科, 浙江杭州 311400
3.
杭州市富阳区妇幼保健院检验科, 浙江杭州 311400

基金项目:

浙江省医药卫生科技计划项目 2019KY555

详细信息

通讯作者:
朱雨晴, E-mail: zhuyuqing0331@126.com

中图分类号: R446 R978.1
计量
- 文章访问数: 128
- HTML全文浏览量: 70
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2020-04-15
- 网络出版日期: 2022-02-16

Comparison of the effect of different antibiotic treatment regimens on intestinal microecology and peripheral blood T lymphocyte subsets in infants

1.
Pharmacy Department, Maternal and Child Health Hospital of Fuyang District, Hangzhou, Zhejiang 311400, China

摘要

摘要: 目的探讨比较不同抗生素治疗方案对婴幼儿肠道微生态和外周血T淋巴细胞亚群的影响。方法选取2019年1—12月杭州市富阳区妇幼保健院72例应用抗生素治疗的婴幼儿为观察组，另选取同院同时期的24例未应用抗生素治疗的健康婴幼儿为对照组。比较2组婴幼儿的肠道微生态和外周血T淋巴细胞亚群结果，同时比较观察组中应用不同抗生素治疗对以上指标的影响。结果观察组与对照组的肠道微生态情况、外周血T淋巴细胞亚群比较差异均有统计学意义(均P＜0.05)；观察组中β-内酰胺类联合非β-内酰胺类抗生素治疗者的乳酸杆菌及双歧杆菌水平低于单用β-内酰胺类与非β-内酰胺类者(均P＜0.05)；观察组中β-内酰胺类联合非β-内酰胺类抗生素治疗者的肠道菌群正常情况为8.33%，显著低于单用β-内酰胺类者(45.83%)与非β-内酰胺类者(58.33%)，差异有统计学意义(均P＜0.05)；观察组中β-内酰胺类联合非β-内酰胺类抗生素治疗者的CD8⁺、CD3⁺、CD4⁺明显低于单用β-内酰胺类与非β-内酰胺类者，差异有统计学意义(均P＜0.05)。结论抗生素β-内酰胺类联合非β-内酰胺类的治疗方案对婴幼儿肠道微生态和外周血T淋巴细胞亚群的影响较大。
- 抗生素 /
- 肠道微生态 /
- T淋巴细胞亚群 /
- 婴幼儿
Abstract: Objective To investigate the effect of different antibiotic treatment regimens on intestinal microecology and peripheral blood T lymphocyte subsets in infants. Methods A total of 72 infants treated with antibiotics in the Maternal and Child Health Hospital of Fuyang District, Hangzhou from January 2019 to December 2019 were selected as the observation group. Meanwhile, 24 healthy infants not administered with antibiotics were selected as the control group. The intestinal microecology and peripheral blood T lymphocyte subsets in both groups were compared. Additionally, the effect of different antibiotic treatment regimens on the above indices in the observation group was compared. Results Differences in intestinal microecology and peripheral blood T lymphocyte subsets between the observation and control groups were significant (all P < 0.05). In the observation group, levels of lactobacilli and bifidobacteria were lower in infants treated with β-lactams combined with non-β-lactams antibiotics than those treated with β-lactams or non-β-lactams alone (all P < 0.05). The proportion of normal intestinal microflora in infants treated with β-lactams combined with non-β-lactams antibiotics (8.33%) was significantly lower than that in those treated with β-lactams (58.33%) or non-β-lactams (45.83%) alone (all P < 0.05). Besides, CD8⁺, CD3⁺ and CD4⁺ were lower than in those treated with β-lactams or non-β-lactams alone (all P < 0.05). Conclusion Treatment with β-lactams combined with non-β-lactams antibiotics greatly influences intestinal microecology and peripheral blood T lymphocyte subsets in infants.
- Antibiotic /
- Intestinal microecology /
- T lymphocyte subsets /
- Infant

HTML全文

图 1 观察组不同抗生素应用方案间肠道菌群水平比较

注：A为乳酸杆菌水平；B为双歧杆菌水平；^aP < 0.01。

下载: 全尺寸图片幻灯片

图 2 不同抗生素应用方案组间外周血T淋巴细胞亚群比较

注：^aP < 0.01。

下载: 全尺寸图片幻灯片

表 1 2组婴幼儿肠道菌群水平比较(x ±s)

组别	例数	乳酸杆菌	双歧杆菌
对照组	24	6.95×10⁷±3.18×10⁸	1.25×10⁸±1.30×10⁸
观察组	72	4.32×10⁴±1.47×10⁵	8.45×10⁶±1.38×10⁷
t值		7.700	10.868
P值		＜0.001	＜0.001
注：t值为菌群水平取对数正态化后计算得出。

下载: 导出CSV

表 2 2组婴幼儿肠道菌群失调情况比较[例(%)]

组别	例数	正常	Ⅰ度失调	Ⅱ度失调	Ⅲ度失调
对照组	24	22(91.66)	2(8.34)	0(0.00)	0(0.00)
观察组	72	27(37.50)	27(37.50)	16(22.22)	2(2.78)
注：2组正常情况比较，χ²=21.134，P < 0.001。

下载: 导出CSV

表 3 观察组中不同抗生素应用方案婴幼儿的肠道菌群失调情况比较[例(%)]

抗生素应用方案	例数	正常	Ⅰ度失调	Ⅱ度失调	Ⅲ度失调
β-内酰胺类	24	11(45.83)	9(37.50)	4(16.67)	0(0.00)
非β-内酰胺类	24	14(58.33)	8(33.33)	2(8.33)	0(0.00)
β-内酰胺类联合非β-内酰胺类	24	2(8.33)^ab	10(41.67)^ab	10(41.67)^ab	2(8.33)^ab
注：与β-内酰胺类比较，^aP＜0.05；与非β-内酰胺类比较，^bP＜0.05。

下载: 导出CSV

表 4 2组婴幼儿外周血T淋巴细胞亚群比较(x ±s，%)

组别	例数	CD3⁺	CD4⁺	CD8⁺
对照组	24	76.99±3.57	49.31±5.41	30.43±8.26
观察组	72	61.54±7.55	35.13±6.76	18.39±4.76
t值		13.437	9.317	6.771
P值		＜0.001	＜0.001	＜0.001

下载: 导出CSV

参考文献(19)

[1]	卢乐声, 徐智芳, 白星, 等. 轻度胃肠炎伴良性婴幼儿惊厥肠道微生物改变的研究[J]. 中华全科医学, 2018, 16(5): 802-804. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201805036.htm
[2]	刘欣欣, 冯爱平. 免疫相关性皮肤病与胃肠道微生态[J]. 中华皮肤科杂志, 2016, 49(1): 1-5. doi: 10.3760/cma.j.issn.0412-4030.2016.01.001
[3]	丁溢芳, 肖玲莉, 郭佳林, 等. 新生儿出生后三天内肠道微生态中菌群分布[J]. 中华围产医学杂志, 2017, 20(7): 507-514. doi: 10.3760/cma.j.issn.1007-9408.2017.07.006
[4]	邹昌文, 胥亚福. 阿莫西林克拉维酸钾、头孢噻肟单用与联用治疗新生儿肺炎的疗效及对肠道微生态的影响[J]. 中国基层医药, 2017, 24(21): 3270-3273. doi: 10.3760/cma.j.issn.1008-6706.2017.21.018
[5]	赵军英, 姜铁民, 陈历俊, 等. 新生儿肠道微生态与孕期营养调节相关性的研究进展[J]. 中华围产医学杂志, 2017, 20(7): 542-545. doi: 10.3760/cma.j.issn.1007-9408.2017.07.013
[6]	纪明宇, 汪运山, 杨炜华. 早期使用抗生素对小儿肠道微生态及生长发育的影响[J]. 中国微生态学杂志, 2017, 29(6): 731-734. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWS201706030.htm
[7]	BRON P A, KLEEREBEZEM M, BRUMMER R J, et al. Can probiotics modulate human disease by impacting intestinal barrier function?[J]. Br J Nutr, 2017, 117(1): 93-107. doi: 10.1017/S0007114516004037
[8]	YANG I, CORWIN E J, BRENNAN P A, et al. The infant microbiome: implications for infant health and neurocognitive development[J]. Nurs Res, 2016, 65(1): 76-88. doi: 10.1097/NNR.0000000000000133
[9]	邢晓枫. 小儿肠道外感染性疾病应用抗生素对肠道菌群的影响[J]. 中国现代药物应用, 2018, 12(15): 144-145. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWYY201815083.htm
[10]	邓小云, 王海涛. 小儿肠道外感染性疾病应用抗生素后肠道菌群失调的相关研究[J]. 中外医疗, 2018, 37(31): 91-92, 95. https://www.cnki.com.cn/Article/CJFDTOTAL-HZZZ201831033.htm
[11]	MADAN J C. Neonatal gastrointestinal and respiratory microbiome in cystic fibrosis: potential interactions and implications for systemic health[J]. Clin Ther, 2016, 38(4): 740-746. doi: 10.1016/j.clinthera.2016.02.008
[12]	SORDILLO J E, ZHOU Y, MCGEACHIE M J, et al. Factors influencing the infant gut microbiome at age 3-6 months: findings from the ethnically diverse Vitamin D Antenatal Asthma Reduction Trial (VDAART)[J]. J Allergy Clin Immunol, 2017, 139(2): 482-491. doi: 10.1016/j.jaci.2016.08.045
[13]	VINDIGNI S M, ZISMAN T L, SUSKIND D L, et al. The intestinal microbiome, barrier function, and immune system in inflammatory bowel disease: a tripartite pathophysiological circuit with implications for new therapeutic directions[J]. Therap Adv Gastroenterol, 2016, 9(4): 606-625. doi: 10.1177/1756283X16644242
[14]	黄清梅, 陆斯良, 陈玉君, 等. β-内酰胺类抗生素及益生菌干预对晚期早产儿肠道菌群的影响[J]. 广西医科大学学报, 2018, 35(5): 664-667. https://www.cnki.com.cn/Article/CJFDTOTAL-GXYD201805020.htm
[15]	孙玄, 专晨昱, 肖均萍, 等. 生后抗生素暴露对早产儿肠道微生态的影响[J]. 中华围产医学杂志, 2018, 21(7): 458-464. doi: 10.3760/cma.j.issn.1007-9408.2018.07.005
[16]	王弘. 不同抗生素治疗方案对新生儿肺炎患者肠道菌落环境的影响观察[J]. 数理医药学杂志, 2018, 31(12): 1829-1831. doi: 10.3969/j.issn.1004-4337.2018.12.044
[17]	DESSELBERGER U. The mammalian intestinal microbiome: composition, interaction with the immune system, significance for vaccine efficacy, and potential for disease therapy[J]. Pathogens, 2018, 7(3): 57. doi: 10.3390/pathogens7030057
[18]	陈红兵, 谭毅. 抗生素对肠道细菌变迁影响的研究进展[J]. 中国临床新医学, 2017, 10(12): 1231-1234. doi: 10.3969/j.issn.1674-3806.2017.12.32
[19]	何国斌, 孙超, 李文浩, 等. 抗生素使用对冬春季婴幼儿肠道菌群内部相关性的影响[J]. 中国妇幼健康研究, 2017, 28(7): 753-757. doi: 10.3969/j.issn.1673-5293.2017.07.002