中文摘要：

目的研究氨溴索联合万古霉素对表皮葡萄球菌RP62A菌株生物被膜（biofilm，BF）的杀菌作用及其结构的影响。方法体外建立RP62A菌株BF模型，分为4组：空白对照组，万古霉素组，氨溴索组，氨溴索＋万古霉素组，用二甲氧唑黄（XTT）比色法测定BF中细菌活力的变化；荧光探针SYT09／PI标记，激光共聚焦显微镜（confocallaserscanningmicroscopy，CLSM）观察，并结合图像结构分析（imagestructureanalyer，ISA）软件对BF结构进行定量分析。结果BF中细菌活力：空白对照组、万古霉素组、氨溴索组、氨溴索＋万古霉素组分别为2．867±0．425，2．869±0．325，1．812±0．210，0．875±0．191；万古霉素组与空白组相比，P〉0．05；氨溴索组、氨溴索＋万古霉素组与空白对照组相比，P〈0．05；氨溴索＋万古霉素组与氨溴索组相比，P〈0．05；表明氨溴索与万古霉素有协同清除作用。CLSM扫描结合ISA软件定量分析显示：氨溴索组，万古霉素＋氨溴索组与空白对照组相比BF厚度、平均扩散距离（averagediffusiondistance，ADD）、结构熵（textualentropy，TE）降低（P〈0．05），区域孔率（ArealPorosity,AV）增加（P〈0．05）；且氨溴索＋万古霉素组与氨溴索组相比作用效果更明显。结论氨溴索与万古霉素存在协同作用，两者联用可使表皮葡萄球菌BF的结构变得简单稀疏，对BF内细菌有明显的杀灭作用。

英文摘要：

Objective To investigate the effect of ambroxol combined with vancomycin on bacterial killing of Staphylococcus epidermidis biofilms （BF） and their structures. Methods In vitro models of 24h RP62A BF were established, and divided into four groups： the blank control group, vancomycin group, ambroxol group, ambroxol and vancomycin group. The metabolic activity of the bacteria inside BF was measured by tetrazolium salt （XTT） reduction assay. BF was stained by SYTO9/PI, monitored by confocal laser scanning microscopy（CLSM）, quantification of the effect be calculated by image structure analyzer （ISA） software. Results For the metabolic activity of the bacteria inside BF, blank control group, vancomycin group, ambroxol group, ambroxol and vancomycin group were 2.867±0.425, 2.869±0.325, 1.812±0.210 and 0.875±0.191. Vancomycin group compared with blank control group have no significant difference, P〉0.05. Ambroxol group, ambroxol and vancomycin group compared with blank control group have significant difference, P〈0.05. Ambroxol ＆ vancomycin group compared with ambroxol group have significant difference, P〈0.05. There was the synergistic effect between ambroxol and vancomycin. From the CLSM images and the data from ISA softwe found that, ambroxol group, ambroxol ＆ vancomycin group compared with blank control group, the thickness, average diffusion distance（ADD）, textual entropy（TE） was reduced（P〈0.05） and areal porosity（AP） was increased（P〈0.05）. In addition ambroxol and vancomycin group had more pronounced effect compared with ambroxol group. Conclusion Ambroxol had the synergistic effect with vancomycin, ambroxol combined with vancomycin could destroyed the structures of Staphylococcus epidermidis biofilms （BF）, made them loose, simole and monolaver, have significant role in the killing of Starhvlococcus eDidermidis BF.