轻微肝性脑病患者小肠细菌过度生长情况研究

Study of small intestinal bacteria overgrowth in patients with minimal hepatic encephalopathy

目的探讨轻微肝性脑病（MHE）患者小肠细菌过度生长（SIBO）情况。方法选择符合入选要求的肝硬化患者90例及20例健康志愿者，进行数字连接试验（NCT-A及NCT—BC）和数字符号试验（DST）诊断MHE，采用葡萄糖氢呼气试验（GHBT）诊断SIBO。结果20例健康志愿者未检出MHE，有1例（5．0％）伴SIBO。90例肝硬化患者共检出MHE38例（42．2％），有28例（31．1％）伴SIBO，其中伴MHE肝硬化患者SIBO21例（55．3％，21／38），不伴MHE肝硬化患者SIBO7例（13．5％，7／52），伴MHE肝硬化患者SIBO发生率明显高于不伴MHE肝硬化患者（r=17．90，P〈0．01）。结论肝硬化患者MHE有较高的发生率，并存在SIBO，伴MHE肝硬化患者SIBO发生率高于不伴MHE肝硬化患者。

Objective To investigate the prevalence of small intestinal bacteria overgrowth（SIBO） in patients with minimal hepatic encephalopathy （MHE）. Methods Ninety patients with cirrhosis and 20 healthy volunteers were studied. All of them were assessed with glucose hydrogen breath test （GHBT） to detect SIBO. And number connection test （NCT-A, NCT-BC） and digit symbol test （DST） were used to diagnose MHE. Results One case （5.0%） out of 20 healthy volunteers was SIBO and none was MHE, and 28 eases （31.1%） out of 90 cirrhosis patients were SIBO and 38 cases （42.2%） were MHE. Twenty-one （55.3%, 21/38 ） cases were diagnosed as SIBO among these patients with MHE, and 7 cases （ 13.5%, 7/52） were diagnosed as SIBO among these patients without MHE. There was significant difference between cirrhosis with MHE and cirrhosis without MHE （X2 = 17.90,P〈 0.01 ）. Conclusions Patients with cirrhosis have a higher prevalence of SIBO. The incidence rate of SIBO in cirrhosis patients with MHE is more than that without MHE.