口腔上皮细胞定植防御的功能潜力作为呼吸道疾病临床病程的指标

O. I. Pikuza, A. M. Zakirova, E. V. Volyanyuk, V. S. Filatov, A. V. Pikuza, A. M. Zakirov
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引用次数: 1

摘要

在儿童发病率的结构中,一类呼吸系统疾病占据了主导地位,从数量上看,这类疾病主要是由急性呼吸道感染形成的。目的:探讨和评价定植防御功能势在呼吸道疾病中的指示意义。本文采用现代研究方法对184例5 ~ 18岁急性支气管炎、复发性支气管炎和社区获得性肺炎患者的菌落抗性指标(菌落指数、口腔上皮人工定植和唾液抗粘附活性)进行了研究。在比较方面,根据呼吸道炎症病变的主题,可以清楚地追踪到本地微生物群(口腔链球菌)在口腔上皮细胞上定植水平的异质性。社区获得性肺炎患者菌落耐药性最高。本组患者的定植指数在0.89(0.07)个标准单位以内(p < 0.01),并伴有口腔上皮细胞明显的白色念珠菌粘附(r = -0.72)。急性支气管炎患者的定植指数为1.86(0.21)个标准单位;支气管炎复发组- 1.27(0.19)个单位(p < 0.01),对照组指标为2.03(0.18)。口咽部中不太典型的微生物的存在反映了定植抗性的减弱,表明了粘膜水平上的不稳定过程。粘膜保护功能储备的缺乏应被视为呼吸道感染过程和呼吸系统细菌炎症过程开始的不利诊断标志。
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Functional potential of colonization defense of buccal epitheliocytes as an indicator of the clinical course of respiratory tract diseases
In the structure of children’s morbidity, one of the leading places is occupied by a class of respiratory diseases, which in quantitative terms is formed mainly by acute respiratory infections. The purpose — to investigate and evaluate the indicator significance of the functional potential of colonization defense in respiratory tract diseases.The paper presents the results of a study of colonization resistance indicators using modern research methods (colonization index, artificial colonization of the buccal epithelium and antiadhesive activity of saliva) in 184 patients aged 5 to 18 years with acute bronchitis, recurrent bronchitis and community-acquired pneumonia.Results. In a comparative aspect, the heterogeneity of the colonization level on buccal epitheliocytes of indigenous microflora (oral streptococci) was clearly traced, depending on the topic of the respiratory tract inflammatory lesion. Colonization resistance suffered the most in patients with community-acquired pneumonia. In patients of this group, the colonization index was within 0.89 (0.07) standard units (p < 0.01), which was combined with a pronounced adhesion of Candida albicans on buccal epitheliocytes (r = -0.72). In patients with acute bronchitis, the colonization index was 1.86 (0.21) standard units; with recurrent course of bronchitis – 1.27 (0.19) units (p < 0.01), while the indicators of the control group were 2.03 (0,18). The presence of less typical microorganisms in the oropharynx reflects the weakening of colonization resistance, signaling destabilization processes focused on the mucous membranes level.Conclusion. The deficiency of the mucosal protection functional reserve should be regarded as an unfavorable diagnostic marker of the course of a respiratory infection and the initiation of a bacterial inflammatory process in the respiratory system.
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