溃疡性结肠炎与小肠细菌过度生长关系探讨

摘要

目的 观察小肠细菌过度生长(small intestinal bacterial overgrowth,SIBO)在溃疡性结肠炎(ulcerative colitis,UC)患者中的发病水平,并评价利福昔明对UC合并SIBO的疗效.方法 选取2016年6月至2017年12月海军总医院就诊,并同时完善甲烷-氢气呼气试验的轻-中度UC患者,共120例.对照组选取同期来院的健康体检者60名.比较两组SIBO阳性率.把UC患者中存在SIBO患者的随机分为A、B两组,A组给予美沙拉嗪治疗(1 g,4次/d,6周);B组给予美沙拉嗪(1 g,4次/d,6周)和利福昔明(0.2 g,4次/d,14 d)治疗,再比较两组的临床疗效、血沉(ESR)和C反应蛋白(CRP).结果 试验组SIBO阳性率明显高于对照组(44.2% vs 21.7%,P<0.01).经过A、B组治疗后,B组的临床疗效、ESR、CRP均优于A组(P<0.05).结论 UC患者的SIBO阳性率明显高于健康人.利福昔明根除SIBO后可显著提高轻-中度UC患者的临床疗效.%Objective To observe the incidence of small intestinal bacterial overgrowth (SIBO) in patients with ulcerative colitis (UC) and to evaluate the effect of Rifaximin on UC with SIBO. Methods From Jun. 2016 to Dec. 2017,120 patients with mild-to-moderate UC and 60 healthy subjects in the General Hospital of Chinese Navy were en-rolled in this study. All subjects underwent Methane and Hydrogen breath test. The positive incidence of SIBO was com-pared between two groups. And then the UC patients with SIBO( +) were randomly divided into two groups(group A and group B). Group A was given Mesalazine (1 g,4 times/d,6 weeks). Group B was given Mesalazine (1 g, 4 times/d,6 weeks) and Rifaximin(0.2 g,4 times/d,14 d). The clinical efficacy,ESR and C reactive protein(CRP) were compared between two groups. Results The positive incidence of SIBO in the experimental group was significantly higher than that in the control group (44.2% vs 21.7%, P<0.01). The clinical curative effect, ESR and CRP of group B were better than those in the group A(P<0.05). Conclusion The positive incidence of SIBO in UC patients is significantly higher than that in healthy people. Treatment of SIBO with Rifaximin can significantly improve the clini-cal efficacy for mild-to-moderate UC patients.