摘要
目的 探讨支气管哮喘患儿急性发作期口咽部菌群的分布特点及长期吸入糖皮质激素对口咽部菌群分布的影响.方法 选择健康儿童60例（健康对照组）和支气管哮喘急性发作期患儿160例,采取其口咽拭子,并于哮喘患儿吸入糖皮质激素治疗后分别随访3个月（89例）、6个月（68例）、12个月（60例）分别采取其口咽拭子,接种于琼脂培养基,分离细菌,按程序鉴定,观察其咽部菌群的分布及吸入糖皮质激素治疗后对其的影响.各组结果采用SPSS12.0统计软件行x2检验和Fisher确切概率法进行比较.结果 支气管哮喘患儿急性发作期口咽部菌群以非β溶血链球菌和革兰阴性球菌为主,携带率均为100%.革兰阴性杆菌、肺炎链球菌和真菌较少.将健康对照组与哮喘急性发作期患儿治疗前、吸入糖皮质激素治疗3个月、6个月、12个月5组进行比较,发现口咽部共检出10个菌种,各菌种检出率差异均无统计学意义,（x2值分别为4.7441、7.8582、1.5583,Fisher确切概率值分别为0.0699、0.6398、0.2433、0.8580、0.6616、0.6339、0.8479,P值均＞0.05）.在支气管哮喘患儿急性发作期检出真菌3株,吸入糖皮质激素治疗后6个月组检出真菌1株,均未发现真菌感染的临床症状.结论 与健康儿童相比较,支气管哮喘急性发作期患儿口咽部菌群分布无明显改变.在吸入糖皮质激素后3个月、6个月及12个月内均未出现口咽部菌群的明显改变.在应用吸入型糖皮质激素治疗支气管哮喘中对咽部菌群进行动态监测具有一定的临床意义.
Objective To explore the effects of inhaled corticosteroids （ICS） on the distribution of throat flora in children with bronchial asthma. Methods Sixty healthy children were included in the study as the control group and 160 children with asthma in acute period before ICS therapy were chosen as the experimental group. The experimental group were treated with ICS therapy. In this group, 89 children were followed up for 3 months, 68 for 6 months and 60 for 12 months. The ICS in the study was budesonide with the trade name as Pulmicort. Swab from the pharynx was used, then inoculated in agar plate. The bacteria were isolated, the distribution and variation of the microbial population in pharyngeal portion were evaluated.The data collected were analyzed using SPSS12.0 software. Results Bacteria could be detected in all samples collected from children with asthma in acute, untreated period, which were mainly non-β-hemolytic streptococcus and gram negative coccobacteria. Gram negative bacilli, streptococcus pneumoniae and mycetes were less. There were no significent differences （x2 value were 4.7441, 7.8582 and 1.5583 respectively,Fisher exact value were 0.0699, 0. 6398, 0.2433, 0. 8580, 0. 6616, 0.6339, and 0.8479 respectively,P＞0.05） among children with asthma in acute period, children with asthma treated with ICS after 3,6 and 12 months and control group. Three strains of mycetes were detected in the experimental group, and one strain in children with asthma treated with ICS for 6 months group. Conclusions There were no significent changes in the distribution of throat flora between the control group and the experimental group. The throat microbiology did not show significent change. Inhaled corticosteroids had no obvious effect in throat flora in children with asthma after being used for a short term and for 12 months, which suggested that inhaled corticosteroids was safe in bronchial asthma treatment.Dynamic monitoring of throat flora while the inhaled corticosteroids are used is of clinical significance.
出处
《中华耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2010年第8期656-659,共4页
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
关键词
哮喘
儿童
细菌
真菌
口咽
糖皮质激素类
Asthma
Child
Bacteria
Fungi
Oropharynx
Glucocorticoids
