粪便pH和涂片检查肠道菌群失调的研究及意义

目的探讨粪便pH和涂片检查细菌球/杆在菌群失调诊断中的价值。方法对腹泻3 d以上或疾病中并发腹泻的194例患者为研究对象。采集新鲜粪便(10 min内),观察其性状、颜色、测pH、粪便常规,涂片革兰染色查细菌总数、形态特点、革兰球菌/杆菌及细菌培养。另选同期住院的非腹泻患者、职工家属和到保健科定期体检的小儿80例作为正常对照。结果经培养确诊为菌群失调的有118例,其中男76例,女42例,年龄最小45天,最大5岁。粪便pH失调组分布在6~8,≥7者占78.8%,对照组分布在5~6.5,多集中在≤5.5,占85%,相比差异有显著性(u=12.02,P<0.01)。涂片查球菌/杆菌失调组为3/7~8/2,球菌≥40%者106例(89.8%),对照组为3/7~1/9,球菌≥40%者无1例,两者比较差异有显著性(u=11.19,P<0.01)。两种快速诊断法的灵敏度分别为94.9%和100%,特异度均为95%,诊断界值pH为6.5,球/杆为3/7。结论粪便pH和涂片检查肠道菌群失调方法简便、快捷、经济实用,能在15 min内作出诊断,尤对急重症患者可赢得治疗时机,值得推广。

The investigation and significance by examining pH value and smear of dejecta for intestinal flora maladjustment

Objective To investigate the value of dejecta pH and smear for the proportion of globate and bacilliform germs in flora maladjustment diagnostic.Methods 194 lax patients for more the 3 days or intercurrent ones were investigated.We collected fresh dejecta(in 10 minutes) and observed character and color.We also examined pH and smear for the sum of germs,form and the proportion of globate and bacilliform germs by G-coloration then cultivated.Comparison group were 80 samples from non lax patients in hospital,employee lax and health infants in health care section office.Results The flora maladjustment group dejecta pH were 6~8,78.8 percent were more than 7. Comparison group dejecta pH value were 5~6.5,85 percent were smaller or equal to 5.5.There was a significant reference between them(u=12.02,P<0.01).We examined the proportion of globate and bacilliform germs by smearing,flora maladjustment group were 3/7~8/2(30/70~80/20),globate germs group 106 were larger than or equal to 40%(89.8%);The comparison group was 3/7~1/9,none sample globate germs group was larger than or equal to 40%.There was a significant reference between them(u=11.19,P<0.01).The sensitivity of the two fast diagnostic methods were 94.9% and 100% respectively.The specificity was 95%.The diagnostic bound pH was 6.5.The proportion of globate and bacilliform germs was 3/7.Conclusions The method of examining pH value and smear for intestinal flora maladjustment was simple,quickly and cheap.It can diagnose in 15 minutes,especially for urgent patients by earning curing chance.It was deserved popularizing.