小肠细菌过生长与非酒精性脂肪性肝病关系的探讨  

Relationship between small intestinal bacterial overgrowth and nonalcoholic fatty liver disease

作　　者：杨雪敏[1] 吕宗舜[1] 王邦茂[1] 戴鑫[1] 

机构地区：[1]天津医科大学总医院消化科,天津300052

出　　处：《天津医科大学学报》2013年第3期223-225,229,共4页Journal of Tianjin Medical University

摘　　要：目的:研究小肠细菌过生长(SIBO)在非酒精性脂肪性肝病(NAFLD)病人中的发生率及其临床意义。方法:收集NAFLD肝功能异常26例,NAFLD肝功能正常32例,健康对照20例。用乳果糖H2呼气试验检测小肠细菌过生长情况并检测相关生化指标。结果:(1)SIBO在NAFLD肝功能异常组的发生率为69.2%,显著高于NAFLD肝功能正常组(31.3%,P<0.05)和健康对照组(10%,P<0.05),后两组间差异无统计学意义(P>0.05);(2)NAFLD肝功能异常组在60 min、90 min时的呼气氢浓度值显著高于肝功能正常组和健康对照组,后两组间比较差异无统计学意义;(3)NAFLD肝功能异常组的口-盲传输时间较NAFLD肝功能正常组(P<0.05)和健康对照组(P<0.05)显著延长。结论:SIBO在NAFLD肝功能异常患者中发生率较高,且多伴有小肠动力异常,因此,通过调节肠道菌群可能会阻止或延缓NAFLD病情的进展。Objective： To investigate the prevalence of small intestinal bacterial overgrowth in patients with nonalcoholic fatty liver dis- and its clinical significance. Methods： 26 NAFLD patients with abnormal hepatic function, 32 patients with normal ease（NAFLD） hepatic function and 20 healthy volunteers were collected, iSmall intestinal bacterial overgrowth was assessed by lactulose breath test and mea- sured their biochemical character. Results： （1） Smail intestinal bacterial overgrowth was present in 69.2% of NAFLD patients with abnor- mal hepatic function, significantly higher than those of NAFLD patients who with normal hepatic function （31.3% ,P〈0.05） and the healthy control group （10%,P〈0.05）,there was no statistically significance between the two latter groups （P〉0.05）; （2） The value of hy- drogen breath concentration in NAFLD patients with abnormal hepatic function at 60 rain and 904~fin were significantly higher than those in normal hepatic function patients and healthy controls, the two latter groups had no statistically significance ; （3）The value of mouth-in- testine transit time in NAFLD patients with abnormal hepatic function were significantly higher than those in the NAFLD patients with normal hepatic function（P〈0.05） and the healthy controls（P〈0.05）. Conclusion： Patients with NAFLD and elevated transaminase have a higher prevalence of small intestinal bacterial overgrowth and gastrointestinal motility disorders, so maybe the progress of nonalcoholic fatty liver disease can be prevented or delayed by regulating the intestinal flora.

关 键 词：小肠细菌过生长 非酒精性脂肪性肝病 肝功能 氢呼气试验 

分 类 号：R575.5[医药卫生—消化系统]