不同类型小肠细菌过度生长的影响因素分析  

Analysis of factors affecting bacterial overgrowth in small intestine of different gas-producing types

作　　者：刘晓娜 王晓辉[2] 王少鑫 刘茜[2] 王巍[2] 董昌昊 胡安平 崔立红 Liu Xiao-Na;Wang Xiao-Hui;Wang Shao-Xin;Liu Xi;Wang Wei;Dong Chang-Hao;Hu An-Ping;Cui Li-Hong(Graduate School,Medical School of Chinese PLA,Beijing 100853,China;Department of Gastroenterology,the Sixth Medical Center of Chinese PLA General Hospital,Beijing 100048,China)

机构地区：[1]解放军医学院研究生院,北京100853 [2]解放军总医院第六医学中心消化内科,北京100048

出　　处：《解放军医学杂志》2025年第3期254-260,共7页Medical Journal of Chinese People's Liberation Army

基　　金：首都卫生发展科研专项(首发2020-2-5113)。

摘　　要：目的 探讨不同类型小肠细菌过度生长(SIBO)的影响因素。方法 选取2021年6-12月于解放军总医院第六医学中心消化内科住院并行甲烷氢呼气试验的539例患者进行回顾性分析。根据甲烷氢呼气试验结果分为SIBO阴性组(n=300)与SIBO阳性组(n=239),比较两组患者的临床资料。根据甲烷氢呼气试验结果将SIBO阳性患者进一步分为产氢菌过度生长组(氢阳组,n=103)、产甲烷菌过度生长组(甲烷阳组,n=80)、产氢菌及产甲烷菌同时过度生长组(双阳组,n=56);采用单因素和多因素logistic回归分析不同类型SIBO的影响因素。根据年龄将SIBO阳性患者分为<45岁(n=23)、45~60岁(n=82)、60~75岁(n=124)、≥75岁(n=10)亚组进行分层分析,比较不同年龄段患者SIBO阳性率的差异。结果 与SIBO阴性组比较,SIBO阳性组和双阳组患者年龄增加,体重指数(BMI)降低,差异均有统计学意义(P<0.05);氢阳组冠心病史比例增高,甲烷阳组年龄增加,他汀类药物应用比例降低,差异均有统计学意义(P<0.05)。多因素logistic回归分析显示,冠心病史是产氢菌过度生长的独立危险因素(OR=2.728,95%CI 1.271~5.857,P=0.010);年龄增长是产甲烷菌过度生长的独立危险因素(OR=1.040,95%CI 1.009~1.063,P=0.010),而他汀类药物应用是其独立保护因素(OR=0.420,95%CI 0.236~0.754,P=0.003);BMI升高是产氢菌及产甲烷菌同时过度生长的独立保护因素(OR=0.870,95%CI 0.786~0.964,P=0.008)。在SIBO阳性组中,<45岁的患者甲烷阳率、双阳率均明显低于氢阳率(P<0.05),45~60岁的患者双阳率明显低于氢阳率(P<0.01);45~60岁、60~75岁的患者氢阳率明显低于<45岁的患者(P<0.05),甲烷阳率、双阳率明显高于<45岁的患者(P<0.01)。结论 冠心病史和年龄增长分别是产氢菌和产甲烷菌过度生长的独立危险因素,他汀类药物应用和BMI升高分别是产甲烷菌过度生长、产甲烷菌及产氢菌同时过度生长的独立保护因素。Objective To explore the influencing factors of different types of small intestinal bacterial overgrowth(SIBO).Methods A total of 539 patients who were hospitalized in the Department of Gastroenterology,the Sixth Medical Center of PLA General Hospital from June 2021 to December 2021 and who underwent methane-hydrogen breath test were retrospectively selected.Based on breath test results,patients were divided into SIBO-negative group(n=300)and SIBO-positive group(n=239).The clinical data were compared between two groups.According to the specific values of breath test results,SIBO-positive patients were further divided into hydrogen-producing bacterial overgrowth(hydrogen-positive,n=103),intestinal methanogen overgrowth(methanogen-positive,n=80),and simultaneous methanogen and hydrogen-producing bacterial overgrowth(double positive,n=56)groups.Multivariate logistic regression analysis was employed to identify influencing factors of different SIBO types.Additionally,SIBO-positive patients were categorized by age into<45 years(n=23),45-60 years(n=82),60-75 years(n=124),and≥75 years(n=10)to compare SIBO positivity rates across age groups.Results The patients in SIBO-positive and double positive groups were older and had a lower body mass index(BMI)than those in SIBO-negative group,with statistically significant differences(P<0.05).Compared with the patients in SIBO-negative group,those in hydrogen-positive group showed a higher proportion of history of coronary heart disease,those in methanogen-positive group were older,and higher proportion of statin use,with statistically significant differences(P<0.05).Multivariate logistic regression analysis revealed that,among different SIBO types,a history of coronary heart disease served as an independent risk factor for hydrogen-producing bacterial overgrowth(OR=2.728,95%CI 1.271-5.857,P=0.010).For methanogen overgrowth,increasing age was identified as an independent risk factor(OR=1.040,95%CI 1.009-1.063,P=0.010),while the application of statin played the role of an indepe

关 键 词：小肠细菌过度生长 呼气试验 产甲烷菌过度生长 产氢菌过度生长 年龄 冠心病 

分 类 号：R574.4[医药卫生—消化系统]