氢呼气试验在功能性肠病患者小肠细菌生长状况分析中的应用

Application of hydrogen breath test in functional bowel disorders patients with small intestinal bacterial overgrowth

目的探讨氢呼气试验在功能性肠病(FBD)患者小肠细菌过度生长情况分析中的应用。方法分析2018年1月至2020年6月首都医科大学宣武医院消化科收治的1224例FBD患者和175例健康志愿者的临床资料,按罗马Ⅳ诊断标准分为功能性便秘(574例)、功能性腹胀(272例)、功能性腹泻(62例)及肠易激综合征组(316例),所有纳入研究的患者和健康志愿者已行乳果糖氢呼气试验,分析检查结果。结果FBD各亚型在小肠细菌过增长(SIBO)阳性率、OCTT延长发生率、回肠反流发生率均高于正常对照组(P<0.05)。功能性便秘组OCTT延长发生率明显高于其他亚型(P<0.05);功能性便秘组OCTT时间明显高于其他亚型(P<0.05),该组SIBO阳性患者OCTT时间明显长于SIBO阴性患者;功能性腹泻组OCTT时间明显短于其他亚型,该组SIBO阳性患者OCTT时间明显短于SIBO阴性患者。结论SIBO与FBD密切相关,明确诊断SIBO可有助于FBD的治疗。各亚型FBD肠道传输时间有不同的表现,LBT可以较准确的反映功能性肠病患者存在的动力情况。氢呼气试验作为一种无创检测方法,可广泛应用于FBD的诊断。

Objective To explore the application of hydrogen breath test in functional bowel disorders(FBD)patients with small intestinal bacterial overgrowth(SIBO).Methods 1,224 patients with FBD enrolled from January 2018 to June 2020 were divided into functional constipation(FC)group(574),functional bloating(FB)group(272),functional diarrhea(FD)group(62),irritable bowel syndrome(IBS)group(316),A11 patients and healthy control group(175)had undergone lactulose breath test(LBT)to detect the prevalence of SIBO,OCTT and ileal reflux.Results All functional bowel subtypes had higher positive rate of SIBO,prolonged rate of OCTT and higher rate of ileal reflux than in normal controls,Differences were significant(P<0.05);The incidence of prolonged OCTT in FC group was significantly higher than that in other subtypes(P<0.05).The OCTT time of FC group was significantly higher than that of other subtypes(P<0.05),the OCTT time of SIBO positive patients in FC group was significantly longer than that of SIBO negative patients;The OCTT time of FD group was significantly shorter than that of other subtypes,and the OCTT time of SIBO positive patients in FD group was significantly shorter than that of Sibo negative patients.Conclusion Small intestinal bacterial overgrowth(SIBO)is closely related to functional intestinal disease.Clear diagnosis of SIBO can contribute to the treatment of FBD.Hydrogen breath test,as a noninvasive test method,can be widely used in the diagnosis of FBD.The intestinal transit time of each subtype of FBD has different manifestations.LBT can accurately reflect the dynamic situation of patients with functional bowel disease.As a non-invasive method,hydrogen breath test can be widely used in the diagnosis of FBD.