质子泵抑制剂与小肠细菌过生长关系的研究

Relationship between the proton pump inhibitors and small intestinal bacterial overgrowth

目的:探讨质子泵抑制剂(PPIs)的使用与小肠细菌过生长(SIBO)发生之间的关系。方法:采用前瞻性对照性研究收集30例服用低剂量PPI的患者、28例服用高剂量PPI的患者,20例健康志愿者作为对照,通过乳果糖呼气H2试验连续观察SIBO的发生情况。结果:低剂量PPI组中SIBO阳性18例,阴性12例,高剂量PPI组阳性22例,阴性6例,对照组阳性1例,阴性19例,低剂量与高剂量PPI组分别与健康对照组比较差异有统计学意义(P<0.01),高剂量PPI组与低剂量组比较差异有统计学意义(P<0.05);两个服药组的SIBO阳性率随服药时间的增加而增加(P>0.05);同一时间段,高剂量PPI组的SIBO阳性率高于低剂量PPI组(P>0.05);两组PPI的使用时间与SIBO阳性率均存在正相关。结论:长期、大量使用PPI的患者可增加小肠细菌过生长的阳性率,可能进一步增加疾病发生的风险。

Objective： To explore the relationship between the proton pump inhibitors（PPIs） and small intestinal bacterial overgrowth（SIBO）. Methods： Thirty patients with low dose PPI, 28 patients with high dose PPI and 20 healthy volunteers were prospectively analysed by lactulose H2 breath test. Results： Eighteen SIBO positive and 12 negative cases in low dose PPI group, 22 SIBO positive and 6 negative cases in high dose PPI group, 1 SIBO positive and 19 negative cases in the volunteer group were observed. Significant difference was found between the two PPI groups and volunteer group（P〈0.01）, as well as between the low dose PPI group and the high dose PPI group（P〈0.05）;Longer duration of PPI therapy, there was accompanied by increased SIBO positive rate（P〉0.05）; With the same duration of PPI use, the SIBO positive rate of high dose PPI group was significantly higher than low dose PPI group（P〉0.05）; A positive relationship was found between the SIBO positive rate and the length of time taking PPI. Conclusion： High dose of PPI in the long term could increase the SIBO positive rate, which could induce some diseases.