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本研究目的探讨成人粪白细胞1–14个/HPF的非血便急性感染性腹泻患者病因学及抗生素应用的参考条件。在成人肠道门诊筛选粪检白细胞1–14个/HPF的非血性急性感染性腹泻患者,留取粪便标本进行细菌培养和病毒检测。196例患者参加了研究,平均年龄(37.9±17.4)岁,女性42.3%。细菌的检出率为63(32.1%),病毒的检出率为21(10.7%)。分离的细菌中,弯曲菌14(22.0%)为最常见菌。病毒分离中,杯状病毒10(47.6%)占第一位。实验室诊断的单一病原感染的侵袭腹泻46例,非侵袭腹泻26例,侵袭腹泻的发热患者体温显著高于非侵袭腹泻的发热患者((38.4±0.7)oC vs(37.7±0.4)oC,P=0.002)。T>38.4 oC的患者为侵袭性腹泻的几率高于T≤38.4 oC的患者(RR=1.5)。成人粪白细胞1–14/HPF的非血性腹泻人群如采用T>38.4 oC作为抗生素应用的界限值,抗生素的过度使用将由26.9%下降至3.8%(P=0.021)。成人粪白细胞1–14/HPF的急性非血性腹泻患者,T>38.4 oC可一定程度上作为应用抗生素的参考。
The aim of this study was to investigate the etiology and antibiotic application of non-haematological acute infectious diarrhea in adult leucocytes 1-14 / HPF. Patients with non-bloody acute infectious diarrhea were screened in adult gut clinics for lecithin 1-14 / HPF, and stool samples were collected for bacterial culture and virus detection. A total of 196 patients participated in the study, with an average age of 37.9 ± 17.4 years and 42.3% of women. The detection rate of bacteria was 63 (32.1%) and the detection rate of the virus was 21 (10.7%). Among the isolated bacteria Campylobacter was the most common bacteria (22.0%). In virus isolation, calicivirus 10 (47.6%) accounted for the first place. Forty-six cases of invasive diarrhea and 26 cases of non-invasive diarrhea were diagnosed in the laboratory. The fever in patients with invasive diarrhea was significantly higher than that in non-invasive diarrhea patients (38.4 ± 0.7 vs 37.7 ± 0.4, P < = 0.002). Patients with T> 38.4 ° C had a higher risk of invasive diarrhea than those with T ≤ 38.4 ° C (RR = 1.5). For patients with non-bloody diarrhea of adult leucocytes 1-14 / HPF, if T> 38.4 oC is used as a threshold for antibiotic use, the overuse of antibiotics will decrease from 26.9% to 3.8% (P = 0.021). T> 38.4 oC for acute non-bloody diarrhea in adult fecal leukocytes 1-14 / HPF may be used as a reference for the application of antibiotics to some extent.