中国危重病急救医学
中國危重病急救醫學
중국위중병급구의학
CHINESE CRITICAL CARE MEDICINE
2008年
9期
520-522
,共3页
抗生素%肠道%细菌%脓毒症%微生态环境
抗生素%腸道%細菌%膿毒癥%微生態環境
항생소%장도%세균%농독증%미생태배경
antibiotics%gut%bacteria%sepsis%microbiogeocoenosis
目的 探讨广谱抗生素对脓毒症大鼠肠道微生态环境的影响.方法 56只健康SD大鼠被随机分为正常对照组、烫伤组和脓毒症组.于大鼠背部造成30%总体表面积Ⅲ度烫伤后24 h,间隔12 h分两次腹腔注射内毒素(20mg/kg)进行"二次打击"制备脓毒症模型.分别于烫伤及"二次打击"后24 h,间隔12 h分两次腹腔注射头孢曲松进行治疗,各组于治疗前及治疗3 d和9 d活杀8只大鼠,取胃窦、小肠、结肠内容物及结肠黏膜行细菌定量培养、菌种鉴定.结果 单纯烫伤对结肠内容物杆菌数量和种类无明显影响,"二次打击"后,杆菌数升高上千倍(P<0.01),应用头孢曲松治疗后大鼠结肠内容物杆菌数量明显减少(P均<0.01),小肠内容物肠杆菌亦有类似变化,而胃内容物肠杆菌数量变化不显著.经烫伤及"二次打击"后肠道杆菌数量显著增加,球/杆比值负值增大;应用头孢曲松后,肠球菌数量显著增多,球/杆比值严重倒置;厌氧菌数量亦有所减少,但差异不显著.结论 广谱抗生素使定植于肠道的厌氧菌和肠杆菌数量锐减,使肠球菌、耐药菌选择为优势菌群成为可能,造成肠道微生态环境破坏.
目的 探討廣譜抗生素對膿毒癥大鼠腸道微生態環境的影響.方法 56隻健康SD大鼠被隨機分為正常對照組、燙傷組和膿毒癥組.于大鼠揹部造成30%總體錶麵積Ⅲ度燙傷後24 h,間隔12 h分兩次腹腔註射內毒素(20mg/kg)進行"二次打擊"製備膿毒癥模型.分彆于燙傷及"二次打擊"後24 h,間隔12 h分兩次腹腔註射頭孢麯鬆進行治療,各組于治療前及治療3 d和9 d活殺8隻大鼠,取胃竇、小腸、結腸內容物及結腸黏膜行細菌定量培養、菌種鑒定.結果 單純燙傷對結腸內容物桿菌數量和種類無明顯影響,"二次打擊"後,桿菌數升高上韆倍(P<0.01),應用頭孢麯鬆治療後大鼠結腸內容物桿菌數量明顯減少(P均<0.01),小腸內容物腸桿菌亦有類似變化,而胃內容物腸桿菌數量變化不顯著.經燙傷及"二次打擊"後腸道桿菌數量顯著增加,毬/桿比值負值增大;應用頭孢麯鬆後,腸毬菌數量顯著增多,毬/桿比值嚴重倒置;厭氧菌數量亦有所減少,但差異不顯著.結論 廣譜抗生素使定植于腸道的厭氧菌和腸桿菌數量銳減,使腸毬菌、耐藥菌選擇為優勢菌群成為可能,造成腸道微生態環境破壞.
목적 탐토엄보항생소대농독증대서장도미생태배경적영향.방법 56지건강SD대서피수궤분위정상대조조、탕상조화농독증조.우대서배부조성30%총체표면적Ⅲ도탕상후24 h,간격12 h분량차복강주사내독소(20mg/kg)진행"이차타격"제비농독증모형.분별우탕상급"이차타격"후24 h,간격12 h분량차복강주사두포곡송진행치료,각조우치료전급치료3 d화9 d활살8지대서,취위두、소장、결장내용물급결장점막행세균정량배양、균충감정.결과 단순탕상대결장내용물간균수량화충류무명현영향,"이차타격"후,간균수승고상천배(P<0.01),응용두포곡송치료후대서결장내용물간균수량명현감소(P균<0.01),소장내용물장간균역유유사변화,이위내용물장간균수량변화불현저.경탕상급"이차타격"후장도간균수량현저증가,구/간비치부치증대;응용두포곡송후,장구균수량현저증다,구/간비치엄중도치;염양균수량역유소감소,단차이불현저.결론 엄보항생소사정식우장도적염양균화장간균수량예감,사장구균、내약균선택위우세균군성위가능,조성장도미생태배경파배.
Objective To study the influence of broad-spectrum antibiotics on intestinal microecology in septic rats. Methods Fifty-six Sprague-Dawley (SD) rats were randomly divided into normal control,burn and sepsis group. Rats in the latter two groups received 30% total body surface area (TBSA) Ⅲ degree burns on back followed by an injection of endotoxin in a dose of 20 mg/kg 24 hours later. The animals in sepsis group were treated with intraperitoneal injection of ceftriaxone 12 hours after the endotoxin challenge in a dose of 60 mg/kg, and it was repeated 12 hours later. Another group of rats received burn injury only.Eight rats in burn group and sep.sis group were sacrificed before ceftriaxone treatment, 3 days and 9 days after the treatment, respectively. The gastric, intestinal and colonic contents were collected for bacterial cultures and species determination. Results The influence of burn injury on the number and species of gut bacteria was not obvious. The addition of endotoxin could markedly increase the number of enteric bacilli in small intestine and colon (both P<0.01), but not in stomach. However, the number of enteric bacilli was sharply decreased in intestine and colon after ceftriaxone treatment (all P<0.01). Furthermore, the ratio of cocci to bacilli was seriously inverted in intestine and colon after ceftriaxone treatment, though burn injury followed by endotoxin had dramatically raise the ratio of cocci to bacilli in intestine and colon. It also produce a loss of anaerobic bacteria in colon, though the difference in number was not statistically significant.Conclusion Broad-spectrum antibiotics could decrease the amount of entericbacilli, making enterococci to be the predominant microbial flora in gut.
