功能性肠病患者小肠细菌过度生长及其预测因素分析

摘要

目的 通过对功能性肠病(FBD)患者进行乳果糖氢呼气试验(LHBT)检测,初步探讨其小肠细菌过度生长(SIBO)的发生率及其预测因素.方法 符合罗马Ⅲ诊断标准的94例FBD患者接受LHBT检测,并根据其结果将FBD患者分为LHBT阳性组和LHBT阴性组,调查其相关的危险因素.结果 94例FBD患者中,LHBT阳性率为32.98%,其中IBS患者LHBT阳性率为33.90%.LHBT阳性组和LHBT阴性组之间的腹胀程度(X2=10.984,p=0.012)、腹胀持续时间(X2=9.873,p=0.020)、抗生素使用时间(X2=10.287,p=0.016)的差异有统计学意义.经多因素Logistic回归分析腹胀持续时间是LHBT阳性的独立预测因子(OR=2.222,95%CI:0.547～9.023,p=0.016).结论 近1/3的FBD患者存在SIBO,腹胀持续时间是FBD合并SIBO的独立预测因子.%Objective To investigate the frequency and predictors of small intestinal bacterial overgrowth ( SIBO) in patients with functional bowel disorders (FBD) by lactulose hydrogen breath test(LHBT). Methods 94 patients with FBD met Rome Ⅲ criteria were tested with LHBT, and then the clinical features were compared between the LHBT-posi-tive and - negative group. Results 31 (32. 98%) patients showed positive LHBTs in 94 FBD patients and 20 (33.90% ) IBS patients had the same results. The severity (X2 =10.984, p=0.012) , and the duration (X2 =9. 873, p=0. 020) of abdominal bloating, the proportion of antibiotics-consumption (X=10. 287 ,p=0. 016) were significantly different between the LHBT-positive and - negative FBD patients. However, Logistic regression analysis showed that only the duration of abdominal bloating is an independent predictive factor of positive-LHBT ( OR = 2. 222 ,95% CI: 0. 547～9. 023 , p=0. 016) . Conclusion SIBO are present in nearly one third of these FBD patients based on the results of LHBT, and the duration of abdominal bloating is an independent predictor of SIBO.