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中华肺部疾病杂志(电子版)

中华肺部疾病杂志(电子版) ›› 2019, Vol. 12 ›› Issue (04) : 458 -462. doi: 10.3877/cma.j.issn.1674-6902.2019.04.011

论著

益生菌制剂在老年肺炎患者治疗中的临床应用
胡明1,†(), 李晓莉1, 甄鹏1, 陈亚利1, 沈宝征1   
  1. 1. 101100　通州，首都医科大学附属北京潞河医院感染性疾病科
  • 收稿日期:2018-07-10 出版日期:2019-08-20
  • 通信作者: 胡明
  • 基金资助:
    益生菌制剂用于老年肺炎治疗的临床研究(KJ2018CX009-33)

Clinical effect and prognosis of probiotics in treatment of senile pneumonia

Ming Hu1,†(), Xiaoli Li1, Peng Zhen1, Yali Chen1, Baozheng Shen1   

  1. 1. Department of Infectious Diseases, Beijing Luhe Hospital, Capital Medical University, Tongzhou 101100, China
  • Received:2018-07-10 Published:2019-08-20
  • Corresponding author: Ming Hu
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胡明, 李晓莉, 甄鹏, 陈亚利, 沈宝征. 益生菌制剂在老年肺炎患者治疗中的临床应用[J]. 中华肺部疾病杂志(电子版), 2019, 12(04): 458-462.

Ming Hu, Xiaoli Li, Peng Zhen, Yali Chen, Baozheng Shen. Clinical effect and prognosis of probiotics in treatment of senile pneumonia[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2019, 12(04): 458-462.

目的

探讨益生菌制剂对老年肺炎患者治疗的临床效果及预后。

方法

选取2016年8月至2018年8月在北京潞河医院收治的124例老年肺炎患者作为研究对象，按照简单随机法分为对照组64例，观察组60例；对照组予以肺炎标准治疗；观察组予以肺炎标准治疗+益生菌制剂。比较两组患者治疗前后腹泻情况、粪便pH值及住院时间，治疗效果，以及菌群失调、真菌感染、再次呼吸道感染、发热发生情况。

结果

观察组患者治疗后腹泻发生率、粪便pH值低于对照组(P<0.05)；对照组患者平均住院时间为(14.62±3.69)d，观察组患者平均住院时间为(10.35±3.11)d，观察组患者住院时间低于对照组(P<0.05)。两组患者治疗有效率分别为75.00%、90.00%，观察组治疗有效率高于对照组(P<0.05)。两组患者治疗前粪便涂片提示：细菌杆球比均≥3︰1、细菌总数为每油镜视野501～5 000个、无真菌感染；观察组患者住院期间、出院后30 d内菌群失调发生率低于对照组(P<0.05)；观察组患者出院后30 d内真菌感染发生率低于对照组(P<0.05)。对两组患者随访30 d，对照组患者发生呼吸道感染16例，发热14例，观察组患者发生呼吸道感染7例，发热4例；观察组患者呼吸道感染、发热发生率低于对照组，二组比较具有统计学差异(P<0.05)。

结论

益生菌制剂应用于老年肺炎患者治疗，可提高治疗效果，降低腹泻、菌群失调发生率，缩短住院时间，改善预后。

关键词: 益生菌制剂, 老年肺炎, 治疗效果, 预后
Objective

To explore the clinical effect and prognosis of probiotics in the treatment of senile pneumonia.

Methods

From August 2016 to August 2018, 124 elderly patients with pneumonia admitted to our hospital were selected as the research objects. They were divided into two groups according to the simple random method. The control group was given standard treatment of pneumonia, while the observation group was given standard treatment of pneumonia plus probiotics. The occurrence of diarrhea, fecal pH value, hospitalization time, therapeutic effect, bacterial imbalance, fungal infection, respiratory tract infection and fever were compared between the two groups before and after treatment.

Results

The incidence of diarrhea and the fecal pH value in the observation group were lower than those in the control group (P<0.05). The average periods of hospital stay were (14.62±3.69) days in the control group and (10.35±3.11) days in the observation group, which had statistical significant difference (P<0.05). The effective rates of treatment were 75.00% in the control group and 90.00% in the observation group, which had significant difference (P<0.05). The smear of the two groups before treatment showed that the ratio of bacteria to the ball was ≥3︰1, the total number of bacteria was 501-5 000 per oil field vision, and no fungal infection was found. Dysbacteriosis occurred in the two groups during hospitalization and within 30 days after discharge, however, the incidence was lower in the observation group than in the control group (P<0.05). The incidence of fungal infection in the observation group was lower than that in the control group within 30 days after discharge (P<0.05). The patients in the two groups were followed up for 30 days. In the control group, there were 16 cases of respiratory infection and 14 cases of fever. In the observation group, there were 7 cases of respiratory infection and 4 cases of fever. The incidence of respiratory infection and fever in the observation group was lower than that of the control group, which had statistical significant difference (P<0.05).

Conclusion

The application of probiotics in the treatment of senile pneumonia can improve the therapeutic effect, reduce the occurrence of diarrhea and dysbacteriosis, shorten the hospitalization time and improve the prognosis.

Key words: Probiotics, Elderly pneumonia, Therapeutic effect, Prognosis
表1 两组患者一般情况比较
组　别 例数 白细胞计数(×109/L) C反应蛋白(mg/L) 主要临床表现(例) 慢性病情况(例)
咳嗽 咳痰 发热 胸痛 高血压 冠心病 糖尿病 脑血管疾病
观察组 60 9.69±2.12 45.43±11.41 49 44 27 35 30 23 8 4
对照组 64 9.52±2.05 43.98±10.27 51 46 25 33 28 21 10 3
χ2/t值   0.9015 1.0681 1.2547 0.8306
P值   0.5732 0.4155 0.238 0.5107
表2 两组患者治疗前后腹泻发生情况、粪便pH值比较
组　别 例数 腹泻(例) 粪便pH值
治疗前 住院期间 治疗前 治疗后
对照组 64 0 9 5.37±0.26 6.60±0.48
观察组 60 0 2 5.41±0.21 5.64±0.42
χ2/t值     4.2573 0.7928 5.0167
P值   1.0000 0.0318 0.6159 0.0142
表3 两组患者治疗效果比较[n(%)]
组　别 例数 治愈 显效 进步 无效 有效率(%)
对照组 64 36(56.25) 12(18.75) 3(4.69) 13(20.31) 75.00
观察组 60 42(70.00) 12(20.00) 2(3.33) 4(6.67) 90.00
χ2值           4.1137
P值           0.0348
表4 两组患者治疗后肠道菌群失调发生情况[n(%)]
组　别 例数 菌群失调 真菌感染
住院期间 出院后30 d内 住院期间 出院后30 d内
对照组 64 13(20.31) 30(46.87) 0(0.00) 13(20.31)
观察组 60 4(6.67) 4(6.67) 0(0.00) 0(0.00)
t值   4.8031 6.1854   5.9125
P值   0.0317 0.0105 1.0000 0.0284
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