难辨梭状芽孢杆菌相关性腹泻的中西医治疗进展

发布时间：2018-05-27 20:52

本文选题：难辨梭状芽孢杆菌相关性腹泻 + 治疗　；参考：《世界华人消化杂志》2012年06期

【摘要】：难辨梭状芽孢杆菌相关性腹泻(Clostridium difficile-associated diarrhea,CDAD)是由难辨梭状芽孢杆菌感染引起的腹泻,是抗生素相关性腹泻中的一个严重亚型.近年来,CDAD因其发病率及严重程度逐年增高,受到各国专家的普遍关注.目前在美国、加拿大和欧洲等国家CDAD的发病率和严重程度显著增加,甚至出现暴发流行.难辨梭状芽孢杆菌是一种革兰阳性肠道病原体,可产生毒素A和毒素B,侵入肠黏膜后引起细胞病变,导致一系列感染相关临床表现.其发病绝大多数与近期内接受广谱抗生素治疗有关,但高龄、慢性病史、长期住院等因素亦为该病发生的危险因素.一旦确诊或高度怀疑本病,应立即停用原有抗生素或换用其他不易导致CDAD的药物,同时应用甲硝唑或万古霉素治疗.近期相关研究表明,除甲硝唑、万古霉素外,还可应用替考拉宁、微生态制剂、单克隆抗体、复方中药制剂等治疗CDAD.本文就难辨梭状芽孢杆菌相关性腹泻的危险因素、治疗与预防方法等研究进展作一综述.
[Abstract]:Clostridium difficile-associated diarrhea is a serious subtype of antibiotic associated diarrhea caused by Clostridium difficile-associated diarrhea. In recent years, the incidence and severity of CDAD have been increasing year by year. At present, the incidence and severity of CDAD in the United States, Canada and Europe have increased significantly, and even outbreaks have occurred. Clostridium Refractoris is a Gram-positive intestinal pathogen which can produce toxin A and toxin B and cause cytopathic changes after invasion of intestinal mucosa leading to a series of clinical manifestations related to infection. The majority of the disease was related to the treatment of broad-spectrum antibiotics in the near future, but the risk factors were old age, chronic history, long-term hospitalization and so on. Once the disease is diagnosed or highly suspected, the antibiotics or other drugs that do not easily cause CDAD should be stopped immediately and treated with metronidazole or vancomycin. Recent studies have shown that in addition to metronidazole and vancomycin, teicoplanin, microecological preparations, monoclonal antibodies, compound Chinese medicine preparations and so on can be used to treat CDAD. This article reviews the risk factors, treatment and prophylaxis of clostridium-associated diarrhea.
【作者单位】：首都医科大学附属北京友谊医院感染内科;
【分类号】：R574

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