Ka11ectbehhblh h kojih'lectbehhblh coctab mhkp0c()jl0pb1 palhlix ot)lejiob jkkt

lloJlocmb pma (pomomomKa). B poTOBOH nonocTH co,uep)Karcg 6orree 300 BH,ll0B MHKpoopraHH3M0B (mmureHHblX H TpaH3HTOpHbIX). O6iuee I<OJrnqecTB0 MHKpo6oB B CJIIOHe M0)KeT)].0CTHraTb 108- 109 KOE/Mn. HHTeH­

CHBHOMY pa3MH0)KeHHlO MHKpoopraHH3MOB B II0JIOCTH pTa cnoco6cTBYlOT 0IITHMaJlbHbie TeMrrepa-rypa H BJia)KH0CTb, IUeJioqnag peal(UHj{ CJilOHbI, HaJIHqHe neo6xo,uHMbIX IlHTaTeJibHbIX BeIUeCTB. KoJIH'-leCTBO amnpo6HblX

6a1crepHH a 10 pa3 npeBbIUiaeT K0JIHqecTBo a3po6oB.

XapaKTepHbie atta3po6Hbie rpaMil0JI0)KHTeJibHble 6aKTepHH npe)].­ CTa13JieHbI.Eubacterium,Lactobacillus,Bifidobacterium,Peptostreptococcus, Propionibacterium u APYrHMH. CpeAH atta3po6ttbIX rpaMOTpuuaTeJibHbIX 6aKTepui1 npeo6na.[(aIOT Bacteroides H Fusobacterium, pe)Ke BcTpeqaioTcg Leptotrichia, Veillonella H Apyrne.

Han6onee MH0ro'-IHGJieHHblMH npe.[(CTaBHreAAMH a3p06HOH MHKpo­ q>JIOpbl gBJigIOTcg Micrococcus spp., Streptococcus spp., a TaK)Ke crncpH­ JI0I<OKKH.

KpoMe roro, B poTOBOH Il0JI0CTH BCTpeqalO'fCj{ MHK0ilJla3Mbl, cnHpo­ xeTI,I, rpH6bI H npocTeHWHe.

BMeCTe co CJIIOHOH n IlHIUeH MHKpoopraHH3MblB 6oJibllIOM K0JIHl.fec­ TBe Il0ila.[(aIOT B IIHIUeB0,U: H,tianee - B)Keny,u:oK.

3a)laeue: H3Y'-IHTb MHKpocpnopy 3y6noro naneTa: B3HTb 3y6noi1 HaJieT y meHKH 3y6a C Il0MOJUblO CTepHJibHOH 3y60'-IHCTKH, C)].eJiaTb Ma30K H 0KpaCHTb no fpaMY HJIH npHT0T0BHTb Ma30K no Byppu, MHKp0CKOilHp0- BaTb, 3apHC0BaTb. BbrnBHTb xapaKTepHbIX npe.[(CTaBHTeJieH MHKpoqmopbI 3y6ttoro ttaneTa.

 

)/(enyoo1<.. Kottu;eHTpau;un MHKpoopraHH3MOB B)Keny,r{Ke pe3I<O na.[(aeT H coCTaanneT He 6onee 103 KOE/Mn, TaK KaK 6naro,u:apg,u:eHCTBHIO congnoi1 KHCJIOTbI)KeJiy.[(0'-IH0ro C0Ka 6oJibllIHHCTBO MHKpoopraHH3MOB noru6aeT.

 

12

 

BbDKHBlllaJI MHKpoq>Jiopa, npeHMyrn;eCTBeHH0 rpaMil0Jl0)KHTeJlbHaJI, Ha­ X0.L(HTC.sl B TOJll.ll;e CJ1H3HCT0ro CJl0.sl H npe.n:cTaBJleHa MHKp0K0KKaMH, JiaK­ To6aQHJ1JiaMH, pe)Ke BCTpe'lalOTC.sl BeHJIJIOHeJlJlhI, 6aKTepOH.L(bl u rpu6br. Cne.n:yei- 0TMeTHTb, 'ITO y HeK0T0pbIX 3.L(Op0BhIX mo.n:eu B CJ1H3HCTOM CJI0e

)Keny.n:Ka 06Hapy)KHBaeTc.s1Helicobacter pylori, KOTOphIH M0)KeT Bhl3hIBaTb racTpHThl H.sl3BeHH)'IO 6oJie3Hb)Keny.n:Ka.

 

TonKUU KUIUetlllUK. ITpoKCHMaJlbHhIH 0T.L(eJl T0HK0ro KHIIIe'IHHKa co.n:ep)KHT He60JlbllIOe K0JlH'leCTB0 MHKpoopraHH3M0B - npHMepH0 103- 105 KOE/r. qarn;e scero BCTpe'laIOTCH J1aKT06aQHJ1J1hI H CTJ)enT0K0KKH. Mano­

'IHCJieHH0CTh MHKpoqmopbl o6ycJIOBJleHa, Il0-BH.L(HM0MY, PM0M npH'IHH: HH3KHMH 3Ha'leHH.slMH pH)Keny.n:Ka, aHTn6aKTepnanhHhIMH CBOHCTBaMH

)KeJI'IH H KHIIIe'IH0ro C0Ka, a TaK)Ke xapaKTepoM HOpMaJJhHOH ABHrareJlbHOH aKTHBHOCTH KHWe'IHHKa.

B AHCTaJlhH0M OT.L(eJie T0HK0r0 KHille'IHHKa ypoBeHb MHKpoopraHH3- M0B noBhIIIIaeTc.si.no 107-108 KOE/r, a HXKa'lecTBeHHhIH cocTaB npu6JIH­

)KaeTc.s1 K C0CTaBy MHKpoq>JiopbI TOJICTOro KHi ll e'I HHKa.

 

ToJ1CmblU KUIUe•muK. B TOJICT0M KHIIIe'IHHKe, oco6eHHO s ero AHC­

TaJlhH0M OT,n:ene, HaX0,lO,fTCH orp0MH0e K0JIH'leCTB0 MHKpoopraHH3M0B, 06rn;a11 Macca K0TOpbIX C0CTaBJIHeT 1,5-3,0 Kr. MHKpOq)Jlopa T0JICToro KHIIIeqHHKa co.nep)KHT.no 500 MHKpo6HhlX BHA0B, o6rn;ee K0JlHqecTB0 MHKpoopraHH3M0B.n:ocTHraeT l012 KOE B rpaMMe q>eKaJIHH. flpeo6mma10-

rn;HMH MHKpoopraHH3MaMH.slBJI.slIOTCH o6nuraTHbie amnpo6&1, Ha HX,[{0JIIO npHX0,[{HTCH 6onee 95% BCeH MHKpO<pJIOpbI.,[(OJIH a3po6oa C0CTaBJIHeT

MeHee 5%.

O6nnraTHaJI MHKpoq>nopa npe,n:cTaBJieHa a 0CH0BH0M 6uq>n.n:o6aK­ TepH.s1MH, 6aKTepoH,naMH, 3y6aKTepHHMH, J1aKT063.UHJIJiaMH (nocne,n:HHe - MHKp o a3p O<pHJibI), nenTOKOKKaMH H.n:pyrHMH rpaMO0JI0)KHTeJihHhlMH aHa3p06HblMH K0KKaMH, nponHOHH6aicrepHHMH, BeHJIJIOHeJIJiaMH. Bee 3TH 6aKTepHH BbICOKOqyBCTBHTeJlbHhl K.n:euCTBHIO KHCJiopo.n:a.

A3p06Hble H <t>aKYJihTaTHBHO aHa3po6Hhie 6aKTepHH npe,n:cTaBJieHbl KHIIIeqHOH nanoqKoH H.n:pyrHMH 3HTepo6aKTepH.s1MH, 3HTep0KOKKaMH, CTa ­

<pHJlOKOKKaMH H.n:p. BcTpeqaIOTC.sl TaIOKe 6aQHJIJihl u KJIOCTpH.l(HH, rpH6bI, HenaToreHHbie npocTeuwue u KHIIIe'IH&Ie aupycbI.

Pa3JIHqaIOT Il0Jl0CTH)'IO (B npocBeTe KHIIIe'IHHKa) H MYK03H)'IO MHKp0-

q>Jio p y, npaKTH'leCKH He 0TJIH'IalOl.ll;YfOCR no BHAOB0MY C0CTaay y 3,n:opoBblX JIJO,n:eH (OTJIH'IH.sl M0ryT IlO.slBHTbC.sl npH naTOJIOrHH).

13

 

MyK03HruI MHKpocpnopa JI0KaJIH3yeTC.ff Ha Il0BepXH0CTii 3ITHTemrnm,­ HbIX KJleT0K, B rny6oKOM cnoe MYK03H0ro rensr KpHilT, B Tonme MYK03Horo rem:1, B 6aKTepuam,Hott 6uonnettKe. OHa 3Ha'lHTem,Ho nyqrne 3alQHIQeHa OT ue6naronpHsrTHb[X B03,UeikTBHH, qeM npocBeTHasr MHKp ocpn op a.

MttKpocpnopa T0JlCT0ro KHlllequHKa BblTI0JIH.sleT MH0rD'lHCJieHHb[C qJH3HOJfOrH'leCKHe, 6HOXHMH'leCKHe H 3alQHTHbie cpyHKUHH (C. 5-6) H, 6na­

ro.uapH CBOCH KOJfOCCaJfbHOM qucneHH0CTH H pa3Hoo6pa.3HOM}' BH,U0B0My cocTaBy, urpaeT Ba)KHe.HrnyJO ponb B no,ll,llep)KaHI-m roMeocTa3a opraHH3Ma qeJJoBeKa,.cne.uosaTenbH0, H B coxpaHem-m ero 3,uopoBhSI.

 

 

Cl>opMHpoBaHHe MHKpo4>J1opb1 TOJICTOro 1rnme'-IHHKa HOBOpO'.lK,l.l;eHHblX H,!(eTeii pa1111c:ro B03pacTa

B TeqeHHe BttyTpHy'Tpo6ttoro pa3BHTlU[ nno.u qeJioBeKa HaX0,UHTCH B CTepIDibHbIX ycJI0BIDIX. BnepBbie pe6eHOK BCTpeqae-rc.si: c Mm<poopraHH3Ma­ MH BO BpeM.si: po,n:oB, conpHKacasrcb co CJJH3HCTbIMH o6onoqKaMH po,noBbIX nyTeH MaTepu. MHKpocpnopa MaTepH nona.uaeT Ha KO)K)', cnmHCTble 060- noqKH, B Il0Jl0CTb pTa, a 3aTeM H B KHille'lHJ-'IK H0B0po)K,D;eHH0ro. B npo­

uecce po,uoB H cpa3y nocne HHX HOBOpo)K,D;eHHhIH pe6eHOK KOHTaKTHpyeT C Me,IlHUHHCKHM nepcoHaJI0M H MHKpoopraHI-t.3MaMH OKp)')KaIOIQeH cp e,Ubl, a 3aTeM IlOBT0pH0 C MaTepbIO BO BpeMsr rpy.unoro K0pMJICHHSI.

MHKpo6mur K0JI0HH3a:QH.sl opraHH3Ma H0B0p0)K,Ll.CHH0ro ocymecTBJI.si:­ eTCH H3.UBYX HCT0'-IHHK0B: 3T0 po,IlOBOH KaHaJI H KO)Ka MaTepH H cpaKTOpbI

oKp)')Karomeii cpe.u:1,1.

TaK KaK OCHOBHylO poJib B cpopMttpoBaHHH MHKpoqmopbl H0B0p0)K­

,I:(CHH0ro ttrpaeT MHKpocpnopa MaTepH (ee BJiaranm.ua, K0)KJ{ H T0JICTOro KHrneqHHKa), peKoMeH,I:(yeTcsr rrpoBepsrTh cocrosrHHe MHKpoqmopbI 6y,rcymeu MaTepH BO BpeMsr 6epeMeHHOCTH. IlpH Bbl}IBJiemrn,I:(J-IC6H03a CJie,I:(yeT npo­ BO.UHTb K0ppeKUHJO MHKpocpnopbI npo6HOTHKaMH.

Ha CTaH0BJleHHe MHKpocpnopbI H0B0po)K,LleHH0ro 0Ka3bIBaI-OT onpe,ne­

JieHHoe BJlIDIHHe caHHTapHoe C0CTo.snrne TIOMemeHHH po,u:.uoMa, (KOJlM'IeCTBO MHKpo6oB B B03,uyxe He,U0Jl)l{H0 npeBbIIIIaTb 1500 K O E /M ³₎ H K0HTaKTbI C Me.u:nepcoHa.rroM.

OrpOMHOe 3Ha'-IeHHe.unsr HOB0p0)l{,UeHHoro HMeeT ecTeCTBCHH0e BCKapMJIHBaHI-1e, K0T0poe BO MH0f0M orrpe.uensreT CKOpOCTh H J<aqecTB0 qlOpMHPYI-Omeilcsr MHKpoqmopbI. B C0CTaB rpy.unoro MOJI0Ka BXO,UHT Bemec­ TBa (OJIHroca:xapH,Ubl, naKTocpeppHH u.up.), OKa3bIBal01QHe 6ttqrn.noreHHbIH

 

14

 

3cp<peKT, TO ecn, CTHMy;rnpy10uu1e HHTeHCHBH0e pa3MH0)l(el\He 6uqm­ JJ,06aKTepmt Ilpeo6na.n:aHHe 6mpH,no6aKTepHH B COCTaBe MHKpoq>JiopLI

,neTeH paHHero B03pacTa TI0BhIIIJaeT HX ycTOH'HIBOCTL K HH<peKQHOHHLIM 3a6oneBaJIIDIM, BJIJ.fj(eT Ha pa3BHTHe MeXaHH3M0B HMM)'HHoro 0TBeTa.

 

llep8Ul/.HaR KOJlOHU3atJWl KUW.el/.HUKa H08opo:>1eoe1-1Ho20 BKJIJOqaeT HeCK0JlhK0 <f>a3:

1- JI <f>a3a--'-acemHqecKaj((10-20 qacoB nocne po)K)];eHIDI) xapaKTepH-

3yeTcJ1 0TCYTCTBHeM  MHKpoopraHH3M0B B KHlll eq  HHKe;

2- JI <pa3a - ttacrynaeT npH6JIH3HTeJihHO qepe3 48 qacos nocne po:>K­

.neHHJI: o6mee KonnqecTBo 6aKTepun.nocnrraeT 10⁹ H 6onee MHKpoopra­ HH3MoB B 1 rpaMMe HCTipIDKHeHHH. 3Ta  <f>a3a xapaKTepH3yeTCj(3aCeJieHHeM

KHmeqHHKa JiaKT06aKTepHJIMH, 3HTepo6aKTepHJIMH, CTa<pHJIOKOKKaMH, 3HTep0K0KKaMH; BCJie)J, 3a HHMH TIOJIBJIJIIOTCJI aHa3po61,1 - 6H<pH.ZJ.06aKTepmt:

u 6aKTepOH)J,LI. J:(aHHLIH:nan emeHecorrpOBO)K,l];aeTCJI <popMHpOBaHHeM

TTOCTOJIHHOH <pJIOpLI.

3- JI <f>a3a - <f>a3a cTa6HJIH3aQHH Hacry n aeT, Kor.n:a 6H<f>H.ZJ.o6aKTepHH cTaHoBJITCJI ocHOBHOH <f>nopoii MHKpo6Horo neH3a:>Ka. Ilpeo6n aHHe 6H­

<pH.ZJ.o6aicrepHH B KHmeqHHKe o6LNHO OTMeqaeTC.sI Ha 9- lO CYTKff)l(H3HH

pe6eHKa.

 

 

CTa6IDIIDaQIDIMHKpo<pnop1,1 KHIIIeqHHKa pe6eHKa He 3aJ<allqJ,l83eTC.sJ B HeOHaTaJThHOM nepHO)le H rrpo.n:oJI:>KaeTC.sJ Bech rrepBblH ro.n:)l(H3HH, a HHOr,lla H 6onee MHTeJILHLIH cpoK. Oco6eHHO OTBeTCTBeHHLIM H HaTip.Jl)KeHHLIM

3TanoM pa3BHTIDI MHKpo<f>nopLI.st:BJIJleTc.si nepeoe nonyro,llHe. J:(JIJ1 JleTeii

nepeoro roJJ,a:>KH3HH xapaKTepHLI BLIC0KHe nonyJIJll.{HOHHLie ypoBHH H qacTOTa BLIJIBJieHIDI He TOJILKO 6Hcp1,i:,no6aKTepHH, JiaKT06aQHJIJI, 3HTepoK0K­

KOB, HenaroreHHLIX 3WepHXHH, HO H 6aKTepHH, K0TOpbie TipHH.sIT0 OTH0CHTh K ycJI0BHo-naroreHHLIMMHKpoopraHH3MaM. 3ro-JieQHTHHa30Il03HTHBHl,Je KJI0CTPH.D:HH, KoaryJia30il03HTHBHhie CTa<f>HJIOKOKKH,.llPO)IOJ{eITO)l06Hbie

rpH6hI poJJ,a Candida, IUITpaTaCCHMHJIHpyiomHe 3IITepo6a1rrepHH H 3We­ pHXHH C HH3KOii 6HOXHMHqecKOH aKTHBHOCThlO, a TaK)l(e co cnoco6HOCThlO K npo.nyKUHH r eMOJIH3HHOB.

K K0Hey nepsoro roJJ,a)l(H3HH, KaK rrpaBHJI0, npOHCXO)J,HT CHH:>KeHHe

K0JIHqecTBa ycJIOBHO-TTaToreHHhIX 6aKTepHH H,Lta:>Ke 3JIHMHHaUHJI HeK0TO­

pi.1x H3 HHX. Ho H B,llByxJieTHeM 803pacTe, KOr)J,a COCTaB MHKpo6:HOUeH031l KHmeqHHKa pe6eHKa B 0CHOBHOM CO0TBeTCTByeT MHKpo<f>nope B3pOCJII,JX JlIO,neii, IIO CBOeH <pH3HOJIOro-6HOXHMHqecKOH aKTHBHOCTH MHKpo<pnopa

15

 

KHilleqHHKa pe6ettKa eu e 3HaqIITeJTbH0 0TCTaeT OT TaKOBOH y B3pocnoro opraHH3Ma.

OcHOBHblMH MeXaHH3MaMH, yqacTBYlOIUHMH B K0HTpone KaqecTBeH­

H0r0 H K0JrnqecTBeHH0ro C0CTaBa MHKpoopraHH3M0B,.SIBJISllOTC.s! cpaKTOpb! ecTeCTBeHHOH pe3HCTeHTH0CTH H a.n.anTHBH0ro HMMYHHTeTa.

KoHTaKThl C 6aKTepHaJTbHblMH aHTHreHaMH onpe.nen.siIOT C03peBaHHe HMMYHHOH CHCTeMI,J. CocTaB MHKpoqmopbI KHIIIeqm1Ka K0CBeHH0 0TpruKaeT oco6eHHOCTH 4>H3HOJIOrw-recKoro COCT0.s!HH.s! KaK 3aI.QH TH bl X, TaK H JJ.pyn-rx CHCTeM opraHH3Ma B pa3JIHqHI,Ie nepH0.D;bl)KH3HH.