目的 分析不同益生菌治疗对抗生素相关性腹泻新生儿肠道微生态和免疫功能的影响。方法 收集2022年1月至2024年1月期间，在本院治疗抗生素相关性腹泻的80例新生儿为研究对象。按照治疗方法的不同分为观察组和对照组，各40例。观察组采用酪酸梭菌二联活菌散治疗，对照组采用双歧杆菌三联活菌散治疗。对比两组的治疗效果、肠道菌群及免疫功能变化情况。结果 两组患儿的性别、年龄、体重、呕吐、发热及开始使用抗生素至腹泻出现时间比较均无差异（P>0.05）。观察组较对照组具有更高的总有效率（P<0.05）。两组患儿治疗前乳酸菌、乳杆菌、双歧杆菌、真杆菌计数无差异（P>0.05）。经过治疗，两组患儿的乳酸菌、乳杆菌、双歧杆菌、真杆菌计数均有所上升，且观察组均高于对照组（P<0.05）。两组患儿治疗前IgA、IgG、IgM无差异（P>0.05）。经过治疗，两组患儿的IgA、IgG、IgM均有所上升，且观察组均高于对照组（P<0.05）。结论 不同益生菌治疗抗生素相关性腹泻新生儿均具有不错的效果，其中酪酸梭菌二联活菌对患儿肠道微生态及免疫功能的作用最为明显
Abstract
Objective To analyze the effects of different probiotic treatments on intestinal microecology and immune function of neonates with antibiotic-associated diarrhea. Methods 80 neonates with antibiotic-associated diarrhea treated in our hospital between January 2022 and January 2024 were collected as study subjects. It was divided into an observation group and a control group of 40 cases each according to the method of treatment. The observation group was treated with Clostridium typhimurium two-live bacterial powder, and the control group was treated with Bifidobacterium bifidum three-live bacterial powder. Compare the treatment effect, intestinal flora and immune function changes of the two groups. Results There was no difference in the comparison of gender, age, weight, vomiting, fever and the time from the start of antibiotics to the appearance of diarrhea between the two groups of children (P>0.05). The observation group had a higher overall effective rate than the control group (P<0.05). There was no difference in the counts of Lactobacillus, Lactobacillus, Bifidobacterium, and Eubacterium before treatment between the two groups (P>0.05). The counts of lactobacilli, lactobacilli, bifidobacteria, and eubacteria increased in both groups after treatment, and they were higher in the observation group than in the control group (P<0.05). There was no difference in IgA, IgG and IgM before treatment between the two groups (P>0.05). The IgA, IgG, and IgM of the children in both groups increased after treatment, and the observation group was better than the control group (P<0.05). Conclusion Different probiotics have good effect in treating newborns with antibiotic-associated diarrhea, among which Clostridium typhimurium diphtheriae has the most obvious effect on the intestinal microecology and immune function of the children.
关键词
益生菌治疗 /
抗生素相关性腹泻 /
新生儿 /
肠道微生态 /
免疫功能
Key words
probiotic therapy /
antibiotic-associated diarrhea /
neonate /
intestinal microecology /
immune function
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参考文献
Tremblay A, Bronner S, Binda S. Review and perspectives on bifidobacterium lactis for infants' and children's health[J]. Microorganisms, 2023, 11(10): 2501.
[2]Avitzur Y, Jimenez L, Martincevic I, et al. Diet management in congenital diarrheas and enteropathies - general concepts and disease-specific approach, a narrative review[J]. Am J Clin Nutr, 2024, 120(1): 17-33.
[3]方峰.抗生素相关性腹泻的预防和诊疗[J].中华儿科杂志,2022,60(7):735-737.
[4]Go A, Lee BH, Choi JH, et al. Case report: a premature infant with severe intrauterine growth restriction, adrenal insufficiency, and inflammatory diarrhea: a genetically confirmed case of MIRAGE syndrome[J]. Front Endocrinol (Lausanne), 2023, 14: 1242387.
[5]Halemani K, Shetty AP, Thimmappa L, et al. Impact of probiotic on anxiety and depression symptoms in pregnant and lactating women and microbiota of infants: A systematic review and meta-analysis[J]. J Glob Health, 2023, 13: 04038.
[6]Lakew G, Yirsaw AN, Bogale EK, et al. Diarrhea and its associated factors among children aged under five years in Madagascar, 2024: a multilevel logistic regression analysis[J]. BMC Public Health, 2024, 24(1): 2910.
[7]Baxter SK, Walsh T, Casadei S, et al. Molecular diagnosis of childhood immune dysregulation, polyendocrinopathy, and enteropathy, and implications for clinical management[J]. J Allergy Clin Immunol, 2022, 149(1): 327-339.
[8]Parvin I, Shahid ASMSB, Nuzhat S, et al. Characteristics and outcomes of children 2-23 months of age with prolonged diarrhoea: A secondary analysis of data from the 'Antibiotics for Children with Diarrhea' trial[J]. J Glob Health, 2024, 14: 04196.
[9]方鹤松,魏承毓.中国腹泻病诊断治疗方案[J].中国实用儿科杂志,1998,13(6):381-384.
[10]Li H, Xiao J, Liao M, et al. 2-week prevalence and associated factors of fever, diarrhea, and coexisting fever and diarrhea among children aged 6-23 months in rural Hunan Province[J]. Sci Rep, 2024, 14(1): 13867.
[11]Kassaw AK, Alebachew Muluneh A, Assefa EM, et al. Predictive modeling and socioeconomic determinants of diarrhea in children under five in the Amhara Region, Ethiopia[J]. Front Public Health, 2024, 12: 1366496.
[12]邹标,舒赛男.益生菌在儿童抗生素相关性腹泻应用进展[J].中国实用儿科杂志,2024,39(1):36-42.
[13]Satty A, Salih M, Abdalla FA, et al. Statistical analysis of factors associated with diarrhea in yemeni children under five: insights from the 2022-2023 multiple indicator cluster survey[J]. J Epidemiol Glob Health, 2024, 14(3): 1043-1051.
[14]Ren J, Ren Y, Mu Y, et al. Microbial imbalance in Chinese children with diarrhea or constipation[J]. Sci Rep, 2024, 14(1): 13516.
[15]Jankiewicz M, Lukasik J, Kotowska M, et al. Strain-specificity of probiotics in pediatrics: a rapid review of the clinical evidence[J]. J Pediatr Gastroenterol Nutr, 2023, 76(2): 227-231.
[16]Szajewska H, Berni Canani R, Domell?f M, et al. Probiotics for the management of pediatric gastrointestinal disorders: position paper of the ESPGHAN special interest group on gut microbiota and modifications[J]. J Pediatr Gastroenterol Nutr, 2023, 76(2): 232-247.
[17]Shah J, Adnan SH, Yousaf MS, et al. A multi-hospital comparative study on the efficacy of probiotics versus placebo in preventing antibiotic-associated diarrhea in adult patients[J]. Cureus, 2024, 16(10): e70881.
[18]Xu H, Wang S, Jiang Y, et al. Poria cocos polysaccharide ameliorated antibiotic-associated diarrhea in mice via regulating the homeostasis of the gut microbiota and intestinal mucosal barrier[J]. Int J Mol Sci, 2023, 24(2): 1423.
[19]Merenstein D, Tan T, Herbin Smith K. Exploratory pilot studies to demonstrate mechanisms of preventing antibiotic-associated diarrhea and the role for probiotics[J]. Ann Fam Med, 2024, 21(3): 4766.
[20]Lukasik J, Dierikx T, Besseling-van der Vaart I, et al. Multispecies probiotic for the prevention of antibiotic-associated diarrhea in children: a randomized clinical trial[J]. JAMA Pediatr, 2022, 176(9): 860-866.
[21]邵兴,童洪杰,陈琨.温阳调肠止泻方对重症监护室抗生素相关性腹泻患者肠道菌群及免疫功能的影响[J].中华中医药学刊,2024,42(9):111-114.
