SPECT/CT结合乳果糖氢呼气试验在肠易激综合征患者小肠细菌过度生长中的诊断价值

Value of SPECT/CT combined with lactulose hydrogen breath test in the diagnosis of small intestinal bacterial overgrowth in irritable bowel syndrome

目的探讨SPECT/CT结合乳果糖氢呼气试验(LHBT)在肠易激综合征(IBS)患者小肠细菌过度生长(SIBO)的临床应用价值。方法采用SPECT/CT扫描仪及手持式微型氢呼气检测仪对134例IBS患者(IBS组)及13例对照组进行SPECT/CT及LHBT检查,记录氢呼气值升高0.005‰的时间,对获得的SPECT/CT图像采用半定量分析法得到核素口盲通过时间(OCTT),并进行统计分析。结果IBS组口服不同剂量温水的核素OCTT比较,差异无统计学意义(t=-0.05,P>0.05);SIBO阳性患者氢呼气值升高0.005‰时间与核素OCTT无明显相关性(r=0.21,P>0.05),SIBO阴性患者与核素OCTT呈明显正相关(r=0.80,P<0.05);IBS组内SIBO阳性患者较阴性患者OCTT时间延长,而氢呼气值升高0.005‰时间提前,差异有统计学意义(t分别=2.21、2.14,P均<0.05)。结论SPECT/CT结合LHBT检查具有无创、准确、简单等优点,可应用于IBS患者SIBO的诊断。

Objective To study the value of SPECT/CT combined with lactulose hydrogen breath test(LHBT)in the diagnosis of small intestinal bacterial overgrowth(SIBO)in irritable bowel syndrome(IBS).Methods Totally 134 IBS patients and 13 controls were tested by general electric emission computed tomography and micro H_(2) meter.The statistical analysis of variance was performed by oro-cecum transit time(OCTT)of radionuclide imaging and the time when the increment of H_(2) value>0.005‰(T5ppm).Results No significant difference was seen in OCTT-i of different doses of warm water between IBS patients and controls(t=-0.05,P>0.05).There was significant correlation between OCTT-i and T5ppm in SIBO negative patients(r=0.80,P<0.05),but no correlation in SIBO positive patients(r=0.21,P>0.05).OCTT-i of SIBO positive patients was longer than SIBO negative patients,but T5ppm was shorter than SIBO negative patients(t=2.21,2.14,P<0.05).Conclusion SPECT/CT combined with LHBT could provide useful information for the exact diagnosis of SIBO in IBS.