甲烷氢呼气试验在非酒精性脂肪性肝病患者中的应用  

Application of hydrogen and methane-based breath testing in patients of nonalcoholic fatty liver disease

作　　者：李瑞 崔立红 LI Rui;CUI Li-hong(The Second School of Clinical Medicine,Southern Medical University(Guangzhou,510280),China;不详)

机构地区：[1]南方医科大学第二临床医学院,广东广州510280 [2]中国人民解放军总医院第六医学中心消化内科

出　　处：《中西医结合肝病杂志》2023年第1期11-14,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：首都卫生发展科研专项项目(No.首发2020-2-5113)。

摘　　要：目的:分析非酒精性脂肪性肝病(NAFLD)患者甲烷氢呼气试验结果,探讨其与小肠细菌过度生长(SIBO)的关系。方法:选取2019年6月至2021年6月通过超声诊断明确的NAFLD患者94例(NAFLD组),健康体检者40例(对照组),所有受试者均接受身高、体重及肝功能、血脂等检测,完善以乳果糖为底物的甲烷氢呼气试验,检测SIBO情况,并进行统计学分析。结果:NAFLD组患者与对照组人员比较,BMI、ALP、TG、LDL、ALT、GGT有统计学差异(P<0.05),TC、AST、TBil、ALB、PT在组间均无统计学差异(P>0.05)。NAFLD组SIBO阳性率为58.51%,且口盲传输时间(OCTT)延长,均高于对照组,差异有统计学意义(P<0.05)。结论:NAFLD患者SIBO阳性率高于健康体检者,且OCTT延长,存在肠动力异常,SIBO阳性患者的症状可能与OCTT及氢气浓度有关,针对SIBO及肠动力的调节可以为NAFLD的治疗提供依据。Objective:To analyze the results of hydrogen and methane-based breath testing in patients with nonalcoholic fatty liver disease(NAFLD)and to investigate its relationship with small intestinal bacterial overgrowth(SIBO).Methods:From June 2019 to June 2021,a total of 94 cases of NAFLD patients were diagnosed by ultrasound and 40 cases of healthy patients were selected for outpatient and in-patient treatment in the department of gastroenterology of our hospital.All subjects were tested for height,weight,liver function,blood lipid,and other indicators.SIBO was detected by hydrogen and methane-based breath testing with lactulose as the substrate and was statistically analyzed with the healthy control group.Results:There were statistically significant differences in BMI,ALP,TG,LDL,ALT,and GGT between the NAFLD group and the healthy control group(P<0.05),and no statistically significant differences in TC,AST,TBil,ALB and PT between the groups(P>0.05).The SIBO positive rate of NAFLD group was 58.51%,and the OCTT was prolonged,which was higher than that of the healthy control group,and the difference was statistically significant(P<0.05).Conclusion:The SIBO positive rate of NAFLD patients is higher than that of healthy people,and OCTT is prolonged,with abnormal intestinal motility,symptoms in patients with SIBO may be related to OCTT and hydrogen concentrations.The regulation of SIBO and intestinal motility can provide a basis for the treatment of NAFLD.

关 键 词：非酒精性脂肪性肝病 甲烷氢呼气试验 小肠细菌过度生长 口盲传输时间 

分 类 号：R575.5[医药卫生—消化系统]