老年人多重用药对小肠细菌过度生长的影响研究

Effects of polypharmacy on small intestinal bacterial overgrowth in elderly subjects

目的探讨老年人多重用药对罹患小肠细菌过度生长(SIBO)风险的影响。方法回顾性分析2017年8月至2021年4月兰州大学第一医院老年病科已行甲烷氢呼气试验(MHBT)的住院患者85例, 根据MHBT检测结果, 分为SIBO(+)组和SIBO(-)组, 用药种类≥5种定义为多重用药, 分析比较两组中多重用药率的差异。结果本研究共纳入85例住院老年患者, 其中SIBO(+)组为38例(44.71%), 多重用药患者为41例(48.24%), 用药种类和多重用药在SIBO(+)和SIBO(-)两组中差异有统计学意义(t=3.01、χ^(2)=14.33, 均P<0.05)。多重用药是SIBO的危险因素(P=0.017, OR=10.85, 95%CI:1.52~77.29)。在14类常见药物中, 胃肠动力消化类药物与SIBO相关。多重用药与90 min时氢气的变化值呈正相关(P=0.040, r=0.22, 95%CI:0.01~0.42)。结论老年人多重用药与SIBO相关, 是SIBO的危险因素。有助于判断SIBO患病风险, 指导进一步检查。

Objective To investigate the effct of multiple medications on the risk of small intestinal bacterial overgrowth(SIBO)in the elderly.MethodsClinical data of 85 inpatients in the Department of Geriatrics,the First Hospital of Lanzhou University undergone HMBT from August 2017 to April 2021 were retrospectively analyzed.According to the HMBT results,they were divided into a SIBO(+)group and a SIBO(-)group.Polypharmacy was defined as≥5 types of medications.We analyzed the difference in the rate of polypharmacy between the two groups.Results A total of 85 hospitalized elderly patients were included in the study.Of these patients,38(44.71%)tested positive for SIBO.Polypharmacy occurred in 41 patients(48.24%).There were significant differences in types of drugs and polypharmacy between the SIBO(+)group and the SIBO()group(t=3.01 and X^(2)=14.33,P<0.05 for both).Moreover,polypharmacy was a risk factor for SIBO(P=0.017,OR=10.85,95%CI:1.52-77.29).Among 14 commonly used drugs,gastrointestinal motility drugs were closely related to SIBO.There was a positive correlation between polypharmacy and the change in hydrogen levels at 90 min(P=0.040,r=0.22,95%CI:0.01-0.42).Conclusions Polypharmacy is correlated with SIBO in the elderly,is a risk factor for SIBO and is helpful in clinical practice to assess the risk of SIBO and decide further examinations,contributing to early diagnosis and early treatment.