乳果糖氢呼气试验评估便秘型肠易激综合征的临床价值

Lactulose hydrogen breath test in evaluating constipation predominant irritable bowel syndrome

目的应用胃肠氢气检测仪测定便秘型肠易激综合征(IBS-C)患者小肠细菌过度生长、口盲传输时间,了解小肠细菌过度生长、口盲传输时间的变化及其与IBS-C的关系。方法选取2013年12月至2015年12月收治的IBS-C组62例及健康对照组30例,通过乳果糖氢呼气试验测定小肠细菌过度生长发生率、口盲传输时间,14C-呼气试验检测幽门螺旋杆菌(Hp)感染情况,比较IBS-C组与健康对照组口盲传输时间差别,进一步比较IBS-C组中小肠细菌过度生长阳性者与阴性者的口盲传输时间、Hp感染率的差别。结果 IBS-C组小肠细菌过度生长发生率高于健康对照组(χ~2=5.313,P=0.022);IBS-C组口盲传输时间较健康对照组明显延长(t=5.083,P=0.000)。在IBS-C患者中,小肠细菌过度生长阳性者的口盲传输时间较小肠细菌过度生长阴性者口盲传输时间明显延长(t=11.972,P=0.000);Hp感染率小肠细菌过度生长阳性者稍高于阴性者,但差异无统计学意义(χ~2=0.125,P=0.723)。结论 IBS-C患者小肠细菌过度生长,口盲传输时间延长,且与IBS-C的动力异常具有一定关系。

Objective To measure and observe the small intestinal bacterial overgrowth（ SIBO） and orocecal transit time（ OCTT） in patients with constipation predominant irritable bowel syndrome（ IBS-C） and explore the associations of SIBO and OCTT with IBS-C. Methods Sixty-two IBS-C patients（ IBS-C group） and 30 healthy volunteers（ control group） were selected from December 2013 to December 2015,and SIBO incidence and OCTT were determined by lactulose hydrogen breath test. The cholesteryl-[14 C]octanoate breath test（14 C-breath test） was used to detect the infection of Helicobacter pylori（ Hp）. The difference of OCTT between two groups and the differences of OCTT and Hp infection rate between positive SIBO patients and negative SIBO patients in IBS-C group were further compared. Results Compared with control group,SIBO incidence was statistically higher（χ~2= 5. 313,P = 0. 022）,and OCTT significantly slowed down in IBS-C group（ t = 5. 083,P = 0. 000）. In IBS-C group,OCTT was significantly longer in SIBO positive patients than that in SIBO negative patients（ t = 11. 972,P = 0. 000）,and there was no statistical difference in Hp infection rate between them even though it was slightly lower in SIBO positive patients（χ~2= 0. 125,P = 0. 723）. Conclusion SIBC and OCTT extension in IBS-C patients may have a certain association with dynamic abnormalities of IBS-C.