目的探讨儿童幽门螺杆菌(H.pylori)感染及抗H.pylori治疗对儿童肠道菌群状态的影响。方法将浙江大学医学院附属儿童医院2004年410月门诊收治的68例慢性胃炎、十二指肠球炎患儿分为H.pylori阳性组36例、H.pylori阴性组32例二组。称取68例患儿新鲜粪便1.0g,分别进行需氧和厌氧培养,分离肠道菌群中最有代表性的三种需氧菌(肠杆菌、肠球菌、酵母菌)和四种厌氧菌(双歧杆菌、乳杆菌、类杆菌、产气荚膜梭菌),菌落记数,同时计算B/E比值来代表定植抗力。对36例H.pylori阳性组中的26例患儿进行“三联”抗H.pylori治疗1周后留取新鲜粪便进行肠道菌群分析,5例患儿在停药1个月后再次进行肠道菌群分析。结果H.pylori阳性组和H.pylori阴性组上述三种需氧菌和四种厌氧菌的菌落检出率比较,差异无统计学意义(P>0.05)。抗H.pylori治疗1周后双歧杆菌、乳杆菌、类杆菌菌落数量较治疗前明显降低(P<0.05),B/E值明显下降(P<0.01),酵母菌的检出率明显增加(P<0.05),产气荚膜梭菌检出率下降(P<0.05)。5例患儿在停药1个月后,乳酸杆菌数量仍继续下降,肠杆菌数量继续增加,双歧杆菌、类杆菌数量有所恢复,但仍低于治疗前。结论儿童H.pylori感染后对肠道菌群影响不大;三联疗法抗H.pylori治疗对儿童肠道菌群产生明显的影响,因此在治疗H.pylori感染时须考虑到大量抗生素治疗后可能对患儿的副作用及潜在的危险。 Objective To investigate the effects of H.pylori infection and anti-H.pylori treatment on intestinal microflora in children. Methods Sixty-eight children with chronic gastritis and duodenal inflammation admitted to the Children’s Hospital of Zhejiang University Medical College in April 2004 were divided into two groups: H.pylori positive group (36 cases) and H.pylori negative group (32 cases). Weigh 68 cases of fresh faeces 1.0g, respectively, aerobic and anaerobic culture, separation of intestinal flora of the most representative of the three aerobic bacteria (Enterobacteriaceae, Enterococcus, yeast) and four kinds of tired Oxygen bacteria (Bifidobacterium, Lactobacillus, Bacteroides, Clostridium perfringens), colony count, while calculating the B / E ratio to represent the resistance to colonization. Twenty-six patients in the H.pylori-positive group of 36 were challenged with “triple” anti-H.pylori treatment for 1 week and then fresh faeces were collected for intestinal microflora analysis. Five patients were retested one month after withdrawal Intestinal flora analysis. Results There was no significant difference in the detection rates of the colony between the above three kinds of aerobic bacteria and the four kinds of anaerobic bacteria in H.pylori positive group and H.pylori negative group (P> 0.05). The number of Bifidobacterium, Lactobacillus and Bacteroides after 1 week of anti-H.pylori treatment was significantly lower than that before treatment (P <0.05), B / E decreased significantly (P <0.01), and the detection rate of yeast <0.05), Clostridium perfringens detection rate decreased (P <0.05). The number of Lactobacilli continued to decrease in 5 children after 1 month of withdrawal, the number of Enterobacteria continued to increase, and the numbers of Bifidobacterium and Bacteroides recovered, but still lower than those before treatment. Conclusions The infection of H.pylori in children has little effect on the intestinal microflora. The anti-H.pylori treatment of triple therapy has a significant effect on the intestinal microflora in children, so the treatment of H.pylori infection may take into account the possibility of antibiotic treatment Side effects and potential risks to children.