乳果糖呼氢试验对肠易激综合征的临床意义

ClinicalSignificance of Lactulose HydrogenBreath TestforIrritable BowelSyndrome

对４９ 例肠易激综合征（ＩＢＳ） 患者和１０ 例对照者进行乳果糖呼氢试验（ＬＨＢＴ） ，测定口回盲瓣通过时间及小肠细菌过度生长的阳性率，对ＬＨＢＴ 阳性者用西沙必利治疗７ ｄ 并进行比较。结果：ＩＢＳ腹泻型及便秘型患者的口回盲瓣通过时间均较对照组明显延长（ Ｐ＜ ０ ．０５） ，２ 型间小肠细菌过度生长的阳性率无差别（ Ｐ＞ ０ ．０５） ，２ 型治疗后口回盲瓣通过时间明显改善（ Ｐ＜ ０ ．０５） ，临床症状好转。提示：小肠动力紊乱可导致小肠细菌过度生长，并可能是肠易激综合征的发病因素之一，ＬＨＢＴ 可为ＩＢＳ的病因探索和治疗提供依据。

Forth nine cases ofirritable bowelsyndrome presenting with diarrhea or constipation and 10 normalcontrols were tested by the lactulose hydrogen breath test to determine the oral cecal passage time,and bacterial overgrowth in the intestines was examined as well;the positive rates were noted . Positive cases were treated with prepulsid for 1 week ,and the pre and post treatment passage times were com pared. The passage times in both the constipation and the diarrhea types of the irritable bowel syndrome were prolonged versus controls ( P< 0 .05) ,butthere was no differencein the rates of bacterial overgrowth in the intestines between the two types ( P> 0 .05) . Oral cecal passage times and clinical sym ptoms were significantly improved after treatment versus pre treatment ( P< 0 .05) .Intestinal moti lity disturbance could lead to bacterial overgrowth , which might be a pathogenic factor in the irritable bowel syndrome . The lactulose hydrogen breath test was an observation parameter to judge clinical therapeutic efficacy .