天津医药

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血液透析患者肠道菌群失调发生及其影响因素

毕学青,姜埃利   

  1. 天津医科大学第二医院
  • 收稿日期:2012-06-20 修回日期:2012-12-27 出版日期:2013-05-15 发布日期:2013-05-15
  • 通讯作者: 姜埃利

The occurrence of dysbacteria in hemodialysis and influencing factor

BIXUEQING ,JIANGAILI   

  1. The Second Hospital Of TianJin Medical University
  • Received:2012-06-20 Revised:2012-12-27 Published:2013-05-15 Online:2013-05-15
  • Contact: JIANGAILI

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摘要：

【摘要】 目的  观察抗生素应用后维持性血液透析患者(HD)菌群失调的发生情况,分析患者菌群失调的影响因素。方法  观察组(HD组)119例为维持性血液透析3个月以上需抗感染治疗的慢性肾脏功能不全患者,对照组110例为同时期入住我院内科的非肾脏及消化道疾病亦需抗感染治疗的患者。2组患者入院后取清晨肘正中静脉血检测肌酐(Cr)、白蛋白(Alb)、血红蛋白(HGB)水平,记录患者一般临床情况,根据患者病情选用抗生素,记录两组患者菌群失调发生情况。采用Logistic回归分析菌群失调的影响因素。结果  抗生素应用后HD组菌群失调发生率为34.5%,高于对照组的17.3%(χ2=8.726,P<0.05);年龄、肌酐、主观综合营养评估(SGA)是菌群失调的影响因素,OR值分别是1.307、1.003、0.316。结论  HD患者抗生素应用后菌群失调发生较正常人群增加,年龄大、肌酐水平高是菌群失调发生的危险因素,SGA评分高为保护因素。 

关键词: 肾透析, 肠, 腹泻, 生态学, 细菌, 细菌感染, 抗菌药

Abstract: Abstract  Objective  To study the incidence rate of dysbacteria after antibiotics applied in hemodialysis patients,expectation to approach the possible correlation between clinic index and dysbacteria. Methods  Those who have taken three more months hemodialysis were the HD group ,all of them needed antibiotic therapy. While the people who need antibiotic therapy but not accompanied by renal or digestive disease were allocate to control group. Recording their clinic index immediately after hospitalization , and the incidence rate of dysbacteria after antibiotics applied.Results   The incidence rate of dysbacteria was 34.5% in HD group while it was 18.1% in the control group; Among these clinic index age,creatinine and SGA is the factor that could impact dysbacteria, regression coefficients were 0.037（p<0.05）,0.003(p<0.05） and -1.152（p<0.001）respectively and OR was 1.307,1.003 and 0.316 . Conclusion   It is true that micro-ecological has been changed in hemodialysis, the incidence of dysbacteria is more often than the control group after antibiotics applied , age,creatinine and SGA is the factor that could impact dysbacteria,SGA is the protect factor.

Key words: Renal dialysis, Intestinal, diarrhea, bacterial infections, Ntibacterial agent