布拉氏酵母菌预防老年下呼吸道感染抗生素相关性腹泻研究

摘要

Objective To investigate the efficacy,safety and side effects of Saccharomyces boulardii(S.boulardii)in the preven-tion and treatment of antibiotic-associated diarrhea(AAD)in elderly patients with lower respiratory tract infections.Methods A total of 127 hospitalized older patients with lower respiratory tract infections admitted in our department from March 2016 to May 2017 were prospectively enrolled in this study, and they were randomly divided into intervention group(n =63, antibiotics +preventive oral administration of S.boulardii powder)and control group(n=64,antibiotics+same volume of placebo).The incidence rate of AAD, other abdominal symptoms,fecal coccus-bacillus ratio and drug side effects were compared between the 2 groups.SPSS statistics 19.0 was used to perform the statistical analysis.Student′s t test,Chi-square test or Fisher exact test was employed for comparison between groups based on different data types.Results The incidence rate of AAD was 11.11%(7/63)and 26.56%(17/64)respectively in the intervention group and the control group.The daily stool frequency was(2.69 ±1.24)and(4.27 ±1.65)times,and the percent-age of the subjects with watery stool were 1.59%(1/63)and 18.75%(12/64), all with significant differences between the 2 groups (P<0.05).There were less patients with fecal coccus-bacillus ratio >1/2 in the intervention group than the control group [3.17%(2/63)vs 18.75%(12/64), P<0.05].No severe adverse reaction related to S.boulardii occurred in the intervention group.Conclusion Preventive administration of S.boulardii can reduce the incidence of ADD,lead to no more obvious side effects compared with routine therapy, and doesn′t cause severe adverse reaction relative to the bacteria in the elderly with lower respiratory infection.%目的 评价在老年下呼吸道感染患者中应用布拉氏酵母菌预防抗生素相关性腹泻(AAD)的有效性、安全性及副作用.方法 选择2016年3月至2017年5月辽宁省金秋医院老年呼吸内科收治的127例接受抗生素治疗的老年下呼吸道感染患者,将患者随机分为干预组(抗生素+预防性口服布拉氏酵母菌散)63例及对照组(抗生素+等剂量安慰剂)64例,分析2组AAD的发病率、其他腹部症状、便球杆比及药物相关副作用方面的差异.采用SPSS 19.0软件对数据统计分析,根据数据类型,组间比较采用t检验、χ2检验或Fisher确切概率法.结果 干预组与对照组AAD发病率分别为11.11%(7/63)及26.56%(17/64),每日排便次数分别为(2.69 ±1.24)及(4.27 ±1.65)次,水样便比例分别为1.59%(1/63)和18.75%(12/64),2组比较差异均有统计学意义(P<0.05).干预组便球杆比>1/2所占比例显著低于对照组,差异有统计学意义[3.17%(2/63)vs 18.75%(12/64),P<0.05].干预组无与布拉氏酵母菌相关的严重不良反应报道.结论 在老年下呼吸道感染人群中预防性应用布拉氏酵母菌能够减少AAD的发生,与常规治疗法比较未增加相关副作用,且未有与布拉氏酵母菌相关的严重不良反应发生.