小肠细菌过度生长相关轻微肝性脑病口–盲通过时间差异性分析

Difference Analysis of the Oral-Cecal Transit Time in Small Intestinal Bacterial Overgrowth Associated Minimal Hepatic Encephalopathy

目的:探讨小肠细菌过度生长(Small Intestinal Bacterial Overgrowth, SIBO)相关性轻微肝性脑病(Minimal Hepatic Encephalopathy, MHE)患者口–盲通过时间(the Oral-Cecal Transit Time, OCTT)情况。方法:选择2021年12月至2023年10月在青岛大学附属医院消化内科住院的符合入选要求的110例肝硬化确诊患者,通过数字连接试验(Number Connection Test-A and Number Connection Test-B, NCT-A和NCT-B)诊断轻微肝性脑病,乳果糖氢呼气试验(Lactulose Hydrogen Breath Test, LHBT)诊断小肠细菌过度生长及明确口–盲通过时间,分为小肠细菌过度生长阳性轻微肝性脑病组、小肠细菌过度生长阴性轻微肝性脑病组、非肝性脑病组,比较三组间口–盲通过时间差异,采用SPSS软件对数据进行统计学分析。呈正态分布的计量资料采用双尾t检验,以x±s表示。计数资料以例数和百分数表示,组间比较采用ANOVA检验。结果:110例肝硬化住院患者中,轻微肝性脑病阳性率为53.6% (59/110),在轻微肝性脑病患者中,小肠细菌过度生长阳性率71.19% (42/59),三组间在口–盲通过时间方面有统计学差异(F = 3.671, P < 0.05),其中SIBO阳性MHE组与非MHE组在口–盲通过时间方面有统计学差异(P < 0.05),与SIBO阴性MHE组在口–盲通过时间有统计学差异(P < 0.05)。结论:小肠细菌过度生长相关轻微肝性脑病的肝硬化患者口–盲通过时间相较于无小肠细菌过度生长和轻微肝性脑病的肝硬化患者延长,消化道动力明显障碍。

Objective: To investigate the oral-cecal transit time (OCTT) of patients with minimal hepatic en-cephalopathy (MHE) associated with small intestinal bacterial overgrowth (SIBO). Methods: 110 pa-tients with liver cirrhosis admitted to the Department of Gastroenterology, Affiliated Hospital of Qingdao University from December 2021 to October 2023 were studied. The minimal hepatic en-cephalopathy was diagnosed by number connection test (NCT-A and NCT-B), and the small intestinal bacterial overgrowth was diagnosed by lactulose hydrogen breath test (LHBT), and the oral-cecal transit time was determined as above. They were divided into three groups: the minimal hepatic encephalopathy group with positive small intestinal bacterial overgrowth, the minimal hepatic en-cephalopathy group without small intestinal bacterial overgrowth, and the negative minimal he-patic encephalopathy group. The differences of oral-cecal transit time among the three groups were compared by SPSS software. The measurement data with normal distribution adopts two-tailed t test, which is expressed by x±s. Counting data were expressed by the number of cases and per-centage, and ANOVA test was used for comparison between groups. Results: Among 110 in patients with liver cirrhosis, the positive rate of minimal hepatic encephalopathy was 53.6% (59/110), among which the positive rate of small intestine bacterial overgrowth in small intestine was 71.19%(42/59). There was a statistical difference among the three groups (F = 3.671, P < 0.05). There was a statistical difference in oral-cecal transit time between SIBO positive MHE group and non-MHE group (P < 0.05), and so as between SIBO negative MHE group (P < 0.05). Conclusions: The oral-cecal transit time of patients with cirrhosis associated with small intestinal bacterial over-growth and minimal hepatic encephalopathy is longer than that of patients without small intestinal bacterial overgrowth and minimal hepatic encephalopathy, and the gastrointestinal motility is ob-viously impaired.