Аннотация
Цель: Изучить клинические проявления и состояние микробиоты кишечника у пациентов с гастроинтестинальной формой постковидного синдрома (ПКС), а также выявить частоту диарейного синдрома и предложить методы реабилитации.
Материалы и методы: В исследовании участвовали 246 взрослых пациентов и 61 ребенок, которые перенесли COVID-19. Проводились комплексные клинико-лабораторные обследования, включая анализ микробиоты кишечника у 116 взрослых. Использовались методы ПЦР, ИФА, бактериологические и биохимические исследования, а также статистическая обработка данных.
Полученные результаты: У 79 % пациентов развился ПКС. Нарушения микробиоты кишечника (II-III степени дисбиоза) выявлены у 56,1 % больных. Снижение количества бифидо- и лактобактерий, рост условно-патогенной микрофлоры (Klebsiella, Candida, Staphylococcus aureus) наблюдались у значительной части пациентов. У детей также отмечались выраженные изменения микробиоты и клинические симптомы (утомляемость, слабость, нарушения пищеварения).
Выводы:
1. У 79 % пациентов, перенесших COVID-19, развивается постковидный синдром, сопровождающийся значительными нарушениями микробиоты кишечника.
2. Основные изменения микробиоты включают снижение бифидо- и лактобактерий, рост условно-патогенной микрофлоры и появление микроорганизмов с атипичными свойствами.
3. Факторами риска ПКС являются женский пол, возраст старше 50 лет, хронические заболевания и применение глюкокортикоидов.
4. У детей с ПКС отмечаются выраженные клинические симптомы и дисбиотические изменения, требующие реабилитации.
Annotation
Objective: To study the clinical manifestations and state of the intestinal microbiota in patients with gastrointestinal postcovoid syndrome (GCS), as well as to identify the frequency of diarrheal syndrome and propose rehabilitation methods.
Materials and methods: The study involved 246 adult patients and 61 children who had suffered from COVID-19. Comprehensive clinical and laboratory examinations were performed, including analysis of the intestinal microbiota in 116 adults. The methods of PCR, ELISA, bacteriological and biochemical studies, as well as statistical data processing were used.
The results obtained: 79 % of patients developed PCOS. Intestinal microbiota disorders (grade II-III dysbiosis) were detected in 56.1 % of patients. A decrease in the number of bifidobacteria and lactobacilli, an increase in opportunistic microflora (Klebsiella, Candida, Staphylococcus aureus) were observed in a significant proportion of patients. The children also showed marked changes in the microbiota and clinical symptoms (fatigue, weakness, and eating disorders).
Conclusions:
1. 79 % of patients who have had COVID-19 develop covid syndrome, accompanied by significant disorders of the intestinal microbiota.
2. The main changes in the microbiota include a decrease in bifidobacteria and lactobacilli, the growth of opportunistic microflora and the appearance of microorganisms with atypical properties.
3. Risk factors for PCOS are female gender, age over 50 years, chronic diseases and the use of glucocorticoids.
4. Children with PKS have marked clinical symptoms and dysbiotic changes that require rehabilitation.
Key words: postcovoid syndrome; intestinal microbiota; dysbiosis; bifidobacteria; lactobacilli; opportunistic microflora; rehabilitation; COVID-19
Список литературы
ЛИТЕРАТУРА (пп. 3-27, 28-31 см. references)
1. Временные методические рекомендации Министерства здравоохранения Российской Федерации «Профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19)». Версия 11 от 05.07.2021. URL: https://static-0.minzdrav.gov.ru/ system/attachments/attaches/000/055/735/original/B%D0%9 C%D0%A0_COVID-19.pdf
2. Ивашкин В.Т., Шептулин А.А., Зольникова О.Ю., Охлобыстин А.В., Полуэктова Е.А., Трухманов А.С. и др. Новая коронавирусная инфекция (COVID-19) и система органов пищеварения. Российский журнал гастроэнтерологии, гепатологии, колопроктологии. 2020; 30; 3: 7–12. DOI: https://doi.org/10.22416/1382-4376-2020-30-3-7
28. Солдатова О.В., Горянская И.Я., Намазова Л.Э.-К., Абрамова К.И. Взаимодействие SARS-CoV-2 с кишечной микробиотой. Экспериментальная и клиническая медицина. 2023; 220 (12): 59–67. DOI:10.31146/1682-8658-ecg-220-12-59-67
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