儿童周期性呕吐综合征与小肠细菌过度生长的关系  

The correlation between cyclic vomiting syndrome and small intestinal bacterial overgrowth in children

作　　者：李宁宁 宋琳[2] 王健[2] 贺兰[2] 任渝棠 季丽娜 徐樨巍[1,2] Li Ningning;Song Lin;Wang Jian;He Lan;Ren Yutang;Ji Lina;Xu Xiwei(Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045,China;Department of Pediatrics,Beijing Tsinghua Changgung Hospital,School of Clinical Medicine,Tsinghua University,Beijing 102218,China)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院,100045 [2]清华大学附属北京清华长庚医院儿科,清华大学临床医学院,102218

出　　处：《中国小儿急救医学》2025年第1期27-32,共6页Chinese Pediatric Emergency Medicine

摘　　要：目的总结儿童周期性呕吐综合征(CVS)临床症状,研究CVS与小肠细菌过度生长(SIBO)的关系。方法选取2020年6月至2023年6月于北京清华长庚医院儿科就诊,确诊为CVS,并同时完善乳果糖氢呼气试验(LHBT)的患儿共89例,为CVS组。选取本院同期健康体检儿童50例为对照组。再根据LHBT结果,将CVS患儿分为SIBO组(LHBT阳性)和非SIBO组(LHBT阴性)。比较各组患儿相关临床资料。结果89例CVS患儿中,男42列,女47例,平均年龄(7.50±3.54)岁;临床常见伴随症状包括嗜睡(76例,85.39%)、厌食(62例,69.66%)、便秘(55例,61.79%)、腹痛(34例,38.20%)等。CVS组患儿与对照组儿童在年龄、性别方面比较,差异无统计学意义(P>0.05)。CVS组患儿体重指数低于对照组;LHBT阳性率高于对照组(56.18%比8.00%),差异有统计学意义(P<0.05),且不同时间点CVS组氢气和甲烷浓度均高于对照组(P<0.05)。89例CVS患儿中,SIBO组50例,非SIBO组39例,两组患儿在性别、年龄、体重指数方面比较,差异无统计学意义(P>0.05)。SIBO组便秘比例、疾病中/重度比例均高于非SIBO组(88.00%比28.21%,94.00%比43.59%),差异均有统计学意义(P<0.05)。结论CVS患儿SIBO发生率较高,SIBO可能是CVS发病的影响因素之一。且存在SIBO的CVS患儿疾病严重程度更高。Objective To summarize the clinical symptoms of cyclic vomiting syndrome(CVS)in children and investigate its association with small intestinal bacterial overgrowth(SIBO).MethodsA total of 89 children who were diagnosed as CVS and improved lactulose hydrogen breath test(LHBT)in the Pediatric Department of Beijing Tsinghua Changgung Hospital from June 2020 to June 2023 were selected as CVS group.Simultaneously,50 healthy children with physical examination in our hospital were selected as the control group.According to the results of LHBT,the children with CVS were divided into SIBO group(LHBT positive)and non-SIBO group(LHBT negative).The clinical data of children in each group were compared.ResultsAmong the 89 CVS patients,there were 42 males and 47 females,with a mean age of(7.50±3.54)years.Common accompanying symptoms included excessive sleepiness(76 cases,85.39%),anorexia(62 cases,69.66%),constipation(55 cases,61.80%),abdominal pain(34 cases,38.20%)and so on.There were no significant differences in age and gender between children in CVS group and control group(P>0.05).The body mass index of CVS group was lower than that of control group.The positive rate of LHBT was higher than that of the control group(56.18%vs.8.00%),the difference was statistically significant(P<0.05),and the concentrations of hydrogen and methane in CVS group were higher than those of the control group at different time points(P<0.05).Among 89 children with CVS,there were 50 cases in SIBO group and 39 cases in non-SIBO group.There were no significant differences in gender,age and body mass index between the two groups(P>0.05).The constipation rate and moderate/severe disease rate in SIBO group were higher than those in non-SIBO group(88.00%vs.28.21%,94.00%vs.43.59%),and the differences were statistically significant(P<0.05).ConclusionThe incidence of SIBO in children with CVS is higher,and SIBO may play a key role in CVS.CVS children with SIBO have higher disease severity.

关 键 词：周期性呕吐综合征 儿童 小肠细菌过度生长 临床症状 

分 类 号：R725.7[医药卫生—儿科]