高齢者における抗生物質起因性腸炎  [in Japanese] Antibiotic-assoxiatied Colitis in Senile Patiens  [in Japanese]

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Author(s)

    • 山門 進 YAMAKADO Susumu
    • 東京都多摩老人医療センター消化器科 Division of Gastroentelrology, Tokyo Metropolitan Tama Geriatric Hospital

Abstract

抗生物質起因性大腸炎は高齢者に多い疾患といわれている. 高齢者においても, 生活様式の変化などにより, その臨床像も変化している可能性がある. そこで, 高齢者を対象とした当院で最近経験した54例, 平均年齢80.5歳を対象とし, 原因抗生物質, 投与期間, 発症までの期間, 基礎疾患, 症状, 検査所見, 治療方法, 予後について retrospective に検討した. 偽膜性大腸炎 (PMC) は急性出血性大腸炎 (AHC)より高齢者, 女性に多い傾向があり, 起因抗生剤はセフェム系, ペニシリン系が多い傾向があった. PMCの症状の trias は下痢, 発熱, 腹痛であり, PMCの基礎疾患は神経精神疾患が多く, AHCでは糖尿病が多かった. 最近のPMCの toxin Aによる発症機序と予防について解説を加え, 報告する.

Antibiotic-associated colitis (AAC) is a relatively frequent disorder in the senile population. Because of the change of life style in the elderly, the clinical pattern of AAC may be varied. The causative antibiotics, duration of adminisration, duration from taking antibiotics to onset of symptoms, background disorders, symptoms, laboratory data, therapies and prognosis in patients with AAC were investigated retrospectively in 54 cases of averaging 80.5 year old in this hospital. The patients with pseudomembranous colitis (PMC) are older and with a greater preponderance of female gender than patients with acute hemorrhagic colitis. Antimicrobial agents that frequently induced AAC are cephalosporins and penicillins. Symptoms in patients with PMC are diarrhea, abdominal cramping pain and fever. The most common background diseases were neurological and psychiatric disorders. Furthermore, recent advances in understanding the mechanism of toxin A-mediated colinic inflammation, and the management of AAC are reported.

Journal

  • Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics

    Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics 39(3), 271-273, 2002-05-25

    The Japan Geriatrics Society

References:  15

Cited by:  5

Codes

  • NII Article ID (NAID)
    10008693780
  • NII NACSIS-CAT ID (NCID)
    AN00199010
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03009173
  • NDL Article ID
    6170607
  • NDL Source Classification
    ZS21(科学技術--医学--内科学)
  • NDL Call No.
    Z19-25
  • Data Source
    CJP  CJPref  NDL  J-STAGE 
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