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目的 了解徐州市丰县和铜山县肠出血性大肠埃希菌 (EHEC)O15 7∶H7引起的出血性结肠炎 (HC)在腹泻病患者中所占的比例 ,以及临床症状和肾功能变化的情况。方法 使用EHECO15 7胶体金快速检测试剂筛选粪便标本 ,阳性者使用免疫磁珠方法分离病原菌。对经过细菌学证实的EHECO15 7∶H7引起的HC患者 ,进行临床症状的观察和生化检验指标分析。结果 2 0 0 0年 5月份 ,丰县由EHECO15 7∶H7引起的HC占腹泻病患者 0 .98% ,6月份铜山县的HC患者占腹泻病患者5 .89%。在出现腹泻病症状的同时 ,18.5 %患者的肾功能已经出现异常 ,表现为尿蛋白、血清肌苷或血尿素氮等指标的升高。在 2 7例HC患者中 ,有 14和 13例分别分离到不产生志贺毒素和产生志贺毒素的EHECO15 7∶H7菌株。根据分离菌株是否产生志贺毒素将患者分为两组进行比较 ,尿蛋白阳性患者的比例分别为 4 / 13和 1/ 14 ,血小板减少患者的比例分别为 6 / 13和 3/ 14。统计学分析有显著意义。提示分离到产生志贺毒素的EHECO15 7∶H7菌株的患者 ,发生肾功能异常的可能性较大。结论 此次调查证实了EHECO15 7∶H7感染所引起的HC在整个腹泻病患者中所占的比例随季节的变化而不同 ,感染产生志贺毒素EHECO15 7∶H7菌株的患者 ,发生肾功能异常的可能性要比不产生志贺?
Objective To understand the proportion of hemorrhagic colitis (HC) caused by enterohemorrhagic Escherichia coli (EHEC) O15 7:H7 in Fengxian County and Tongshan County of Xuzhou City in patients with diarrhea and the clinical and renal changes Happening. Methods EHECO157 colloidal gold rapid detection reagent screening stool specimens, the positive method using immunomagnetic beads isolated pathogens. Clinical observations and biochemical analysis of HC patients with bacteriologically confirmed EHECO15 7:H7 were performed. Results In May 2000, HC accounted for 0.98% of patients with diarrhea due to EHECO15 7:H7 in Fengxian County and 5.89% of patients with HC in Tongshan County in June. In the presence of symptoms of diarrhea, 18.5% of patients had abnormal renal function, manifested as urinary protein, serum creatinine or blood urea nitrogen and other indicators of increased. Of the 27 HC patients, 14 and 13 were isolated from the EHECO15 7:H7 strain that did not produce Shiga toxin and Shiga toxin, respectively. According to whether the isolates produced Shiga toxin or not, the patients were divided into two groups. The proportion of urinary protein positive patients was 4/13 and 1/14 respectively, and the proportion of patients with thrombocytopenia was 6/13 and 3/14 respectively. Statistical analysis of significant significance. Prompt separation of Shiga toxin-producing EHECO15 7:H7 strains of patients, the possibility of renal dysfunction. Conclusion This investigation confirms that the proportion of HC caused by EHECO15 7:H7 infection in patients with diarrhea varies with the seasons. Patients infected with Shiga toxin EHECO15 7: H7 strain have renal dysfunction Possibility than not produce Shiga?