质子泵抑制剂相关小肠细菌过生长与血清炎症因子的研究  

The correlation between small intestinal bacterial overgrowth associated with proton pump inhibitor and serum inflammatory markers

作　　者：柯纪定 韩跃华[2] 马海峰 车海滨 倪卫国 

机构地区：[1]宁波市镇海龙赛医院消化内科,浙江宁波315200 [2]浙江大学医学院附属第二医院消化内科,浙江杭州310008

出　　处：《中国微生态学杂志》2016年第5期538-540,543,共4页Chinese Journal of Microecology

基　　金：宁波市医学科技计划项目(甬卫发〔2014〕80号)(2014A38)

摘　　要：目的观察长期应用质子泵抑制剂(PPI)患者,在强效抑酸状态下小肠细菌过生长(SIBO)的发生情况;及观察发生SIBO的患者中血清TNF-α变化。方法用葡萄糖呼气H2试验(GBT)检测176例服用PPI制剂患者,35名慢性胃炎志愿者作为对照;同时,对71例服用PPI SIBO患病者(PPI+SIBO阳性组)检测血清TNF-α,32例服用PPI未发生SIBO者(PPI+SIBO阴性组)作为对照组。结果 PPI组GBT阳性111例(63.1%),阴性65例(36.9%);对照组中GBT阳性6例(17.1%),阴性29例(82.9%)。PPI组SIBO发病率显著高于对照组(P<0.001),应用趋势卡方、逐步Logistic回归分析得知PPI使用时间、年龄与SIBO患病率存在正相关性(P<0.001、P<0.05)。PPI+SIBO阳性组71例检测TNF-α,其中38例TNF-α>8.1pg/mL(53.5%);对照组(PPI+SIBO阴性组)32例中TNF-α>8.1pg/mL 3例(9.4%),两组之间差异有统计学意义(P<0.001)。结论长期服用PPI制剂的患者可并发SIBO,且SIBO的患病率与PPI制剂使用时间、年龄呈正相关。然而,SIBO者更易出现血清慢性亚临床炎症状态。这也提示长期服用PPI可发生慢性亚临床炎症状态。Objective To observe the situation of small intestinal bacterial overgrowth（SIBO）under the circumstance of potent acid suppression in patients accepting proton pump inhibitor（PPI）and investigate the correlation between serum inflammatory markers,TNF-α,with SIBO.Methods 176 patients who were given PPI（PPI group）and 35 volunteer patients with chronic gastritis without PPI（volunteer group）were detected by using glucose H2 breath test（GBT）;The 71 patients with GBT positive result（PPI SIBO positive group）and 31 patients with GBT negative result（PPI SIBO negative group）were detected for serum TNF-α.Results 111patients（63.1%）in PPI group were GBT positive,while 6（17.1%）in Control group were GBT positive（P〈0.001）.The elevated incidence of SIBO was positively associated with time of taking PPI（P〈0.001）and age of patients（P〈0.05）.There were 38 patients with serum TNF-α8.1pg/mL in PPI SIBO positive groups（53.5%）,while in the volunteer group there were 3 with serum TNF-α8.1pg/mL（9.4%）（P〈0.001）.Conclusion Patients taking PPI over a long period of time can get SIBO subsequently and the incidence of SIBO is correlated positively with the length of time taking PPI and age.The levels of TNF-αin patients with SIBO were higher than those without SIBO,suggesting that long-term use of PPI may result in chronic subclinical inflammation.

关 键 词：质子泵抑制剂 小肠细菌过生长 TNF-Α 

分 类 号：R378[医药卫生—病原生物学]