CAJ | 학술논문

目的：探讨预防性使用氟康唑不同的时间对肠道真菌增殖及易位的影响。方法 Wistar大鼠30只、雌雄不限，随机分为三组，每组大鼠每天均按体质量比例使用头孢哌酮舒巴坦钠直至取实验动物标本，每组动物均在第7天始分别加用生理盐水或氟康唑行腹腔注射，生理盐水使用3d（A组），氟康唑使用3d（B组），氟康唑使用5d （C组）后各组取血液、肠系膜、胰腺、肺组织及肠内容物行真菌培养，同时检测血浆1‐3‐β‐D葡聚糖水平。结果与A组比较，B组和C组肠道真菌数量明显减少（P＜0．05）、血浆1‐3‐β‐D葡聚糖水平相应明显下降（P＜0．05）；与B组比较，C组肠道真菌数量显著减少（P＜0．05）、血浆1‐3‐β‐D葡聚糖水平也明显下降（P＜0．05），与A组、B组比较， C组真菌易位至肠外组织器官总数均明显减少（P＜0．05）。肠道真菌增殖分别与血浆1‐3‐β‐D葡聚糖水平和真菌易位至肠外组织器官总数呈正相关（ r＝0．943和0．923），真菌易位至肠外组织器官总数与血浆1‐3‐β‐D葡聚糖水平呈正相关（ r＝0．998）。结论预防性使用氟康唑可以明显减少肠道真菌增殖及易位，预防用药5天比较合适，血浆1‐3‐β‐D葡聚糖检测有助于深部真菌感染早期诊断。
목적：탐토예방성사용불강서불동적시간대장도진균증식급역위적영향。방법 Wistar대서30지、자웅불한，수궤분위삼조，매조대서매천균안체질량비례사용두포고동서파탄납직지취실험동물표본，매조동물균재제7천시분별가용생리염수혹불강서행복강주사，생리염수사용3d（A조），불강서사용3d（B조），불강서사용5d （C조）후각조취혈액、장계막、이선、폐조직급장내용물행진균배양，동시검측혈장1‐3‐β‐D포취당수평。결과여A조비교，B조화C조장도진균수량명현감소（P＜0．05）、혈장1‐3‐β‐D포취당수평상응명현하강（P＜0．05）；여B조비교，C조장도진균수량현저감소（P＜0．05）、혈장1‐3‐β‐D포취당수평야명현하강（P＜0．05），여A조、B조비교， C조진균역위지장외조직기관총수균명현감소（P＜0．05）。장도진균증식분별여혈장1‐3‐β‐D포취당수평화진균역위지장외조직기관총수정정상관（ r＝0．943화0．923），진균역위지장외조직기관총수여혈장1‐3‐β‐D포취당수평정정상관（ r＝0．998）。결론예방성사용불강서가이명현감소장도진균증식급역위，예방용약5천비교합괄，혈장1‐3‐β‐D포취당검측유조우심부진균감염조기진단。
Objective To investigate the effects of the prophylactic use of fluconazole on cefoperazone induced in‐testinal fungal multiplication and translocation .Method 30 Wistar rats which included the male or female were ran‐domly divided into three groups .Cefoperazone sulbactam sodium was used in the rats of each group every day unto the end of the study .After the seventh day used antibiotic ,normal saline was injected for 3 days (group A) ,while fluconazole was used for 3 days in group B and for 5 days in group C .The intestinal contents ,mesenteric ,pancreat‐ic ,lung tissue and blood of each group were cultured for fungal ,and plasma 1‐3‐beta‐D glucan was measured .Result The number of the intestinal fungi and plasma 1‐3‐beta‐D glucan in group B and group C was significantly decreased (P<0 .05) compared with group A .Compared with group B ,the number of intestinal fungi and plasma 1‐3‐beta‐D glucan in group C was significantly reduced (P<0 .05) ,the total number of fungal translocation to the parenteral tissues in group C was significantly reduced than that in group A and B (P<0 .05) .The multiplication of intestinal fungal was positively correlated with plasma 1‐3‐beta‐D glucan level and fungal translocation (r=0 .943 and 0 .923) , fungal translocation was positively correlated with plasma 1‐3‐β‐D glucan (r=0 .998) .Conclusion Prophylactic use of fluconazole can significantly reduce the multiplication and translocation of intestinal fungal and it is more appropri‐ate to use for 5 days in prophylaxis after used antibiotic .It is helped to detect plasma 1‐3‐beta‐D glucan for early di‐agnosis of deep fungal infections .