小肠细菌过度生长与小肠肿瘤的关系及其临床意义

Significance of small intestinal bacterial overgrowth in small intestinal tumors

目的:研究小肠肿瘤患者小肠细菌过度生长(small intestinal bacterial overgrowth,SIBO)的发生情况及观察应用利福昔明治疗SIBO能否改善小肠肿瘤患者胃肠道症状.方法:采用葡萄糖氢呼气试验(glucose hydrogen breath test,GHBT)检测小肠肿瘤组28例与健康对照组30例,并对所有患者行消化系症状评分,SIBO阳性患者在原有治疗的基础上给予利福昔明治疗,疗程结束后复查GHBT,观察并记录呼气氢浓度及消化系症状评分变化情况.结果:小肠肿瘤组SIBO阳性率(57.14%)显著高于健康对照组(3.33%),差异有统计学意义(P<0.05);肿瘤组SIBO阳性患者(7.50±3.14)消化系症状积分高于SIBO阴性患者(4.00±3.22),差异有统计学意义(P<0.05).SIBO阳性患者经利福昔明治疗后复查GHBT,呼气氢浓度和消化系症状积分较治疗前均下降,差异均有统计学意义(P<0.05).结论:小肠肿瘤患者较健康人更容易发生SIBO,且SIBO可能是加重患者消化系症状的原因之一.应用利福昔明治疗SIBO后,患者消化系症状改善,一定程度上提高了患者的生活质量.

AIM： To investigate the relationship between small intestinal bacterial overgrowth （SIBO） and tumors of the small intestine and to observe the role of rifaximin in improving gastrointestinal symptoms in patients with small intestinal tu- mors and SIBO. METHODS： Glucose hydrogen breath test （GHBT） was performed to evaluate the incidence rate of SIBO in 28 patients with small intestinal tumors and 30 healthy volunteers. Hydrogen levels during GHBT and gastrointestinal symp- tom scores were recorded. All the patients were treated routinely, and patients with positive SIBO results were additionally given oral rifaxi- min （1200 mg/d for 5 d）. GHBT was performed again after rifaximin treatment, and hydrogen levels and gastrointestinal symptom scores were recorded again. RESULTS： There was a in the SIBO positive rate small intestinal tumors significant difference between patients with and healthy controls （57.14% vs 3.33%, P 〈 0.05）. Gastrointestinal symptom scores were significantly higher in patients with small intestinal tumors than in healthy controls （P 〈 0.05）. After treatment with rifaximin, hydrogen levels declined significantly （P 〈 0.05）. There was a significant difference be- tween pretreatment and post-treatment gastro- intestinal symptom scores （10.72 ± 2.19 vs 8.83 ± 0.79, P 〈 0.05）. CONCLUSION： Patients with small intestinal tu- mors are more likely to have SIBO than healthy individuals. SIBO may be a reason for aggrava- tion of digestive tract symptoms in patients with small intestinal tumors. Appropriate application of rifaximin can improve gastrointestinal symp- toms in patients with small intestinal tumors and SIBO.