甲烷氢呼气试验对原发性肾病综合征患儿小肠细菌过度生长的检测

Detection of overgrowth of small intestinal bacteria in children with primary nephrotic syndrome by methane-hydrogen breath test

目的通过甲烷氢呼气试验对原发性肾病综合征(PNS)患儿小肠细菌过度生长情况进行评估,探索PNS患儿小肠细菌情况。方法本研究于2021年3月至2022年3月招募30例PNS患儿(PNS组)和34例体检者(对照组)为研究对象,采用甲烷氢呼气试验检测受试者小肠的菌群生长情况。分析PNS与小肠细菌生长情况的相关性。结果PNS组共有16名PNS患儿合并小肠细菌过度生长(SIBO),SIBO患病率为53.3%(95%CI:11.1%~89.7%);而对照组有26.5%的儿童患有SIBO,组间差异有统计学意义(χ^(2)=4.8314,P=0.0279)。两组儿童年龄、性别、常住地比较差异均无统计学意义(均P>0.05)。PNS合并SIBO的患儿白细胞水平显著低于未合并SIBO的患儿(F=6.2797,P=0.0201)。Pearson分析显示,PNS组中SIBO阳性患儿服用乳果糖后呼出气体变化量与血清中胆固醇水平具有相关性(P<0.05)。结论PNS患儿更容易发生SIBO,临床可对此类患者进行针对性治疗。

Objective To evaluate the small intestinal bacterial overgrowth(SIBO)in children with primary nephrotic syndrome(PNS)by methane-hydrogen breath test.Methods A total of 30 children with PNS(PNS group)and 34 subjects with physical examination(control group)were recruited from March 2021 to March 2022.A methane-hydrogen breath test was used to detect the growth of bacteria in the subjects'small intestines.Then the association between PNS and small intestine bacterial growth condition was analyzed.Results Sixteen children with PNS had SIBO,and the prevalence of SIBO was 53.3%(95%CI:11.1%-89.7%).By comparison,26.5%of the children in control group had SIBO.The difference between two groups was statistically significant(χ2=4.8314,P=0.0279).There were no significant differences in age,gender,and permanent residence between the two groups(all P>0.05).The leukocyte count in children with nephrotic syndrome complicated with SIBO was significantly lower than that in those without SIBO(F=6.2797,P=0.0201).Pearson correlation analysis showed that the change in exhaled air after lactulose administration was correlated with serum cholesterol level in SIBO-positive patients in the case group(P<0.05).Conclusion The children with PNS were more prone to SIBO;targeted treatment can be carried out for the children with PNS.