溃疡性结肠炎患者肠壁微生物检查的处理

O. Davydova, О Е Давыдова, P. Andreev, Петр Степанович Андреев, S. Katorkin, С Е Каторкин, A. Lyamin, А. В. Лямин, I. Kiseleva, Инна Викторовна Киселева, L. Lichman, Л А Личман, S. A. Bistrov, С А Быстров
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摘要

溃疡性结肠炎(UC)是一种常见病,发病率呈逐年上升趋势。这种疾病主要影响活跃工作年龄的年轻人。发病率高峰出现在20-29岁和50-55岁。目的:通过对溃疡性结肠炎患者结肠壁菌群的微生物学检查,通过纠正抗菌药物治疗,优化溃疡性结肠炎患者的诊断和治疗。材料与方法:选取2017年1 - 5月在SamSMU门诊结肠科和消化内科接受门诊和固定治疗的溃疡性结肠炎患者35例,年龄28 ~ 61岁,平均年龄37.6岁。其中男性18例(48.6%),女性17例(51.4%)。结果。发现了显著的微生物群落物种多样性,需要精确的物种鉴定和开发标准程序,从溃疡性结肠炎患者的生物酸盐中分离微生物,目的是给予抗菌治疗。在分离菌株对抗生素的敏感性分析中,发现45%的分离微生物对1-2组药物有耐药迹象,33%的分离微生物对3组及以上药物有耐药迹象。只有22%的菌株被发现对所有测试制剂敏感。根除这种菌群有一定的困难,在我们看来,需要在生物检查后进行联合治疗。结论。所有溃疡性结肠炎患者都需要检查肠壁的微生物组成,以优化诊断和治疗。10 5 -10 6滴微生物,其广泛的物种多样性可能支持结肠炎症并阻止缓解。因此,有必要从比较的角度继续研究结肠壁微生物组成,以优化溃疡性结肠炎患者的诊断和治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Management of patients with ulcerative colitis with account of microbiological examination of bioptate of colon wall
Ulcerative colitis (UC) is a common disease with the evident tendency to annual increase in incidence. The disease mostly affects young individuals of active working age. The peak of incidence of the disease is observed at the age of 20-29 and 50-55 years. The aim of study was optimization of diagnostics and management of patients with ulcerative colitis by correction of antibacterial therapy on the basis of the data of microbiological examination of the microflora of the wall of colon. Materials and Methods. 35 Patients with ulcerative colitis from 28 to 61 years of age with the average age 37.6 years who underwent outpatient and stationary treatment in colonoproctology and gastroenterology departments of SamSMU clinics in the period from January to May 2017 were examined. Of them, 18 were males (48.6%) and 17 females (51.4%). Results. Significant species diversity of microflora was identified that requires exact species identification and development of standard procedures for isolation of microorganisms from bioptates of patients with ulcerative colitis with the aim of administration of antibacterial treatment. In analysis of sensitivity of the isolated strains to antibiotics 45% of the isolated microorganisms were found to have signs of resistance to 1-2 groups of medical drugs, and 33% showed signs of resistance to 3 and more groups. Only 22% of strains were found to be sensitive to all tested preparations. Eradication of such flora presents certain difficulties, and in our opinion, requires administration of combined therapy after examination of bioptate. Conclusions. All patients with ulcerative colitis require examination of the microbial composition of the intestinal wall for optimization of diagnostics and treatment. 10 5 -10 6 titer of microorganisms, their wide species diversity may support inflammation in the colon and prevent relief. It is necessary to continue study of microbiological composition of the colonic wall in the comparative aspect for optimization of diagnostics and management of patients with ulcerative colitis.
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