@article{oai:niigata-u.repo.nii.ac.jp:00023914,
 author = {稲庭, 謙一},
 issue = {9},
 journal = {新潟医学会雑誌, 新潟医学会雑誌},
 month = {Sep},
 note = {Immunological examinations were carried out on 63 patients suffering from Antibiotic-associated Colitis (AAC) in order to ascertain whether type I allergy or cellular immunity is closely associated with the pathogenesis of AAC. Fecal cultures and colonoscopic observation were also conducted. Colonoscopic features of AAC were divided into three types, Pseudomembranous type (PMC type), Aphthoid type (APH type) and Erosive hemorrhagic Type (EH type). LMT positive rate for causative antibiotics were 0%, 17%, 13% and 8% in PMC, APH, EH and control, respectively. There were no significant differences statistically between the control and the other 3types. Concerning drug eruption, peripheral eosinophilia and serum IgE level, there were also no significant differences between the control and the other 2 types of APH and EH type. Remarkable infiltration of eosinophils was not observed histologically in the biopsy specimens. All lesions of the PMC type were found in the rectum, and the lesions extended to the entire colon including rectum were found in the cases more than half of PMC type. Lesions of EH type were mostly found in the transverse colon, but rectal lesions were found only in 33% of EH type. The distribution of APH type lesions were similar to those of PMC type. Cephems antibiotics caused lesions of APH type in many cases of AAC, whereas many penicillins antibiotics caused lesions of EH type. Concerning fecal cultures findings, Clostridium difficile was detected in 21% of AAD, 80% of PMC type, 25% of APH type and 21% of EH type. Klebsiella oxytoca was detected in 8% of AAD and 31% of AAC. Staphylococcus aureus and Pseudomonas aeruginosa were found approximately in 10% of cases of AAC and AAD. Fifty five percent of AAD cases and 67% of AAC cases were confirmed with severe disorder of intestinal flora. These facts examined above suggest that severe disorder of intestinal flora is deeply concerned with the pathogenesis of AAC, and allergy of type I or type IV to administered antibiotics is not responsible for the pathogenesis of AAC., 抗生物質起因性大腸炎(AAC)の発症に起因抗生物質に対するI型アレルギー及び細胞性免疫の関与の有無を知る目的で,AAC 63例について免疫学的検査を行った.また糞便の細菌検査,大腸内視鏡検査も併せて行った.AACにおける起因抗生物質に対するLMT陽性率は偽膜型0%,アフタ型17%,びらん出血型13%,対照8%であり,各病型と対照との問に推計学的有意差はなかった.AAC のアフタ型とびらん出血型では,薬疹,末梢血好酸球増多,血清IgE値ともに対照との問に有意差はみられず,大腸生検組織像にも著明な好酸球浸潤はみられなかった.大腸内視鏡所見では,偽膜型は全例ともに直腸に病変がみられ,半数以上に全大腸にも病変を認めた.びらん出血型は横行結腸に病変が最も多く,直腸の病変は少なかった.アフタ型は偽膜型とよく似た病変分布を示した,抗生物質の種類との関係については,セフェム系抗生物質によるAACではアフタ型の病変が多く,ペニシリン系抗生物質のそれではびらん出血型が多かった.糞便中のclostridium difficileは偽膜型の80%,アフタ型の25%,びらん,出血型の21%の症例に検出した.Klebsiella oxytocaはAAC の31%の症例で,Staphylococcus aureusやPseudomonas aeruginosaもAACの10%前後の症例に検出した.以上のことから,AACの発症には起因抗生物質に対するI型及びIV型アレルギーの関与は殆どなく,腸内細菌叢の極端な乱れが何らかの形で関与しているものと推測した.},
 pages = {567--576},
 title = {抗生物質起因性大腸炎(Antibiotic-associated Colitis)に関する臨床的研究},
 volume = {101},
 year = {1987}
}