功能性胃肠病患者小肠细菌过度生长的临床特征分析

Analysis of clinical characteristics of intestinal bacterial over growth in patients with functional gastrointestinal diseases

[目的]通过对功能性胃肠病(FGIDs)患者中小肠细菌过度生长(SIBO)与临床特征(性别、年龄、体质指数、临床症状)的调查分析,探讨SIBO与FGIDs临床症状的相关性。[方法]对符合纳入标准的FGIDs患者的临床表现进行整理分析,并进行乳果糖氢和甲烷呼气试验(LHMBT)检测SIBO是否存在。对其阳性者予以常规剂量与疗程的利福昔明片治疗,并观察其治疗效果。[结果]138例符合罗马Ⅳ诊断标准的FGIDs患者接受了LHMBT,74例LHMBT阳性(53.6%)提示SIBO存在,SIBO阳性与阴性患者中性别、年龄、BMI组间比较差异无统计学意义,其临床症状组间比较差异有统计学意义(P<0.05)。临床症状为嗳气、腹泻、便秘的患者更有可能发生SIBO,其中嗳气组的OR为1.333,95%CI为0.346~5.136;腹泻组的[OR]为1.333,95%CI为0.603~2.948];便秘组的OR为1.717,95%CI为0.417~7.603;采用利福昔明片治疗SIBO后,康复5例,好转59例,无效10例,症状好转率为86.5%(64/74)。[结论]FGIDs与SIBO密切相关,嗳气、腹泻、便秘或是FGIDs患者发生SIBO的潜在预测因子,使用利福昔明治疗SIBO可以改善FGIDs患者的临床症状。

[Objective]To investigate the correlation between SIBO and the clinical symptoms of functional gastrointestinal diseases(FGIDs)by investigating and analyzing the clinical characteristics(gender,age,BMI,clinical symptoms)of SIBO in patients with functional gastrointestinal diseases(FGIDs).[Methods]The clinical manifestations of FGIDs meeting the inclusion criteria were analyzed,and the presence of SIBO was detected by lactulose-hydrogen and methane breath test(LHMBT).The positive patients were treated with routine dose and course of rifaximin tablets,and the therapeutic effect was observed.[Results]The totals of 138FGIDS patients who met RomanⅣdiagnostic criteria received LHMBT,74of them were LHMBT positive(53.6%),suggesting the existence of SIBO.There was no statistically significant difference in gender,age and BMI between SIBO-positive and SIBO-negative patients,but there was statistically significant difference in clinical symptoms between the two groups(P<0.05).Patients with clinical symptoms of belching,diarrhea and constipation were more likely to develop SIBO,and the odds ratio[OR]of the belching group was 1.333,and the 95%CI was 0.346-5.136.The ORand 95%CI of the diarrhea group were 1.333and 0.603-2.948.The OR in the constipation group was 1.717,95%CIwas 0.417-7.603.After the treatment of SIBO with rifaximin tablets,5patients recovered,59patients improved and 10patients were ineffective.The improvement rate of symptoms was 86.5%(64/74).[Conclusions]FGIDs are closely related to SIBO,and belching,diarrhea and constipation are potential predictors of SIBO in patients with FGIDs.Treatment of SIBO with rifaximin can improve the clinical symptoms of patients with FGIDs.