the Estimation of a role of microbiological changes at a syndrome of an angry intestine. A syndrome of superfluous bacteriemic growth
The structure of a microflora of the person depends on features of immune reactions, a food, a way of life, the transferred infections and agents of their treatment, and also an available chronic pathology [57, 76, 146].
It is proved, that the microflora of excrements of patients SRK essentially differs from a microflora of healthy faces [18, 67, 92, 134, 218]. Importance disbioticheskih changes at SRK consists in ability of an intestinal microflora to develop nejrotransmittery, influencing on ENS, that, in turn, changes secretion, a motility of an intestine and a threshold of visceral sensitivity [30]. The Finnish authors a method quantitative polimeraznoj chain reaction (PTSR) tap significant differences in the maintenance of some sorts of bacteria, such as Coprococcus, Collinsella and Coprobacillus [218]. Results of the quantitative analysis of a microflora of a colon at SRK testify to essential depression of obligate flora (bifidobaktery, laktobaktery, enterococci). Representatives of an is conditional-pathogenic microflora (staphilococcuses, hemolitic strains of an intestinal rod, protej, mushrooms of sort Candida) are sowed often fromExcrements of patients SRK, but their difference with indicators of healthy faces doubtfully [16, 131].
In modern researches special value is given to studying of communication of a syndrome of superfluous bacteriemic growth (SIBR) with development of chronic diseases of an intestine [4, 18, 212]. According to different sources, SIBR has been found out in 30-85 % of patients SRK [4, 211, 152, 171, 175, 190, 195, 209]. SIBR - a pathological condition at which in a lumen of proximal department of a small bowel it is found out more, than 105 WHICH/ML. As a rule, SIBR it is characterised by superfluous growth of mainly fecal microflora, including 141 strain of aerobes (such, as Streptococci (60-71 %), Escherichia coli (3669 %), Staphylococci (13-25 %), Micrococci (22 %), Klebsiella (11-20 %)) and 117 strains anaerobov (such, as Bacteroides39 %, Lactobacillus25 %, Clostridium 20 %) [52, 54, 90, 107, 208, 211]. SIBR initiates inflammatory changes in a mucosa of a small bowel which, in turn, strengthen clinical implications of intestinal dysfunctions. In some cases SIBR is the reason of development of a microscopical inflammation of a small bowel: uploshchenie villuses, pathological changes of cryptás, augmentation intraepitelialnyh lymphocytes (IEL) [52, 151, 211]. It is important to notice, that in the presence of SIBR in a small bowel lumen disturbance of level secretory IgA becomes perceptible, that can have reflexion in disturbance of mechanisms of the control of number of bacteria [17, 52]. Many authors note presence SIBR and its participation in a pathogenesis at SRK [18, 26, 92, 143, 172, 207, 211], but there is also an opposite opinion that SIBR does not play any essential role in pathogenesis SRK [210].
As a result of the changed intestinal microflora, substances (free cholic acids, gidroksidy fat acids, bacteriemic toxins, proteases) and various metabolites (Phenolums, biogenic amines, etc.), influencing a motility of an intestine and a condition of its receptor apparatus [16, 29, 31, 60, 93, 140, 185, 208, 211] are developed. Special value have korotkotsepochechnye monokarbonovye acids and their salts which concentration at patients SRK is lowered. At SRK the bacteriemic proteolysis, that changes
Influences on slizeobrazovanie. As a result of disturbance of power supply of a mucosa of an intestine the hypoxia develops, the trophicity is broken, the dysbacteriosis is aggravated, function of goblet cells and structure glikoproteinov changes, that, in turn, reduces protective functions of a mucosa and influences a threshold of painful sensitivity. The vicious vicious circle promoting maintenance of arisen changes of a motility and sensitivity of the receptor apparatus of an intestine [11, 29] is as a result framed.
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