Lisowska Aleksandra, Wójtowicz Jerzy, Walkowiak Jarosław
Department of Pediatric Gastroenterology and Metabolism, Poznań University of Medical Sciences, Poznań, Poland.
Acta Biochim Pol. 2009;56(4):631-4.
Hydrogen breath test (BT) is commonly used as a diagnostic tool for the detection of small intestine bacterial overgrowth (SIBO). It was reported that colonic methane production is far more frequent in cystic fibrosis (CF) patients than in other subjects. Therefore, measuring exclusively hydrogen in the diagnostic breath test for diagnosing SIBO might be of limited value. We aimed to assess the usefulness of combined measurement of hydrogen and methane expiration for the diagnosis of SIBO in CF.
The study comprised 62 CF patients aged 5 to 18 years. Three-hundred-ninety subjects assessed due to gastrointestinal symptoms for the presence of SIBO served as a comparative group. In all subjects hydrogen/methane BT using glucose was performed. A positive BT was defined as fasting hydrogen > or = 20 ppm or fasting methane > or = 10 ppm or a rise of > or = 12 ppm hydrogen or > or = 6 ppm methane over baseline during the test.
In 23 (37.1%) CF patients and in 52 (13.3%) subjects from the comparative group abnormal BT results were found. In seven (11.3%) CF patients and 29 (7.4%) of the other subjects studied methane measurement allowed diagnosis of SIBO.
Small intestine bacterial overgrowth is frequent in cystic fibrosis. For its detection in cystic fibrosis and other gastrointestinal patients, combined hydrogen and methane measurement instead of hydrogen breath test should be applied. Without the additional measurement of methane a significant percentage of SIBO will be missed.
氢呼气试验（BT）通常用作检测小肠细菌过度生长（SIBO）的诊断工具。据报道，囊性纤维化（CF）患者结肠甲烷生成比其他受试者更为常见。因此，在诊断SIBO的呼气试验中仅测量氢气可能价值有限。我们旨在评估联合测量氢气和甲烷呼出量对CF患者SIBO诊断的实用性。
该研究纳入了62名5至18岁的CF患者。390名因胃肠道症状接受SIBO评估的受试者作为对照组。对所有受试者进行了使用葡萄糖的氢/甲烷BT检测。BT阳性定义为空腹氢气≥20 ppm或空腹甲烷≥10 ppm，或检测期间氢气比基线升高≥12 ppm或甲烷比基线升高≥6 ppm。
在23名（37.1%）CF患者和52名（13.3%）对照组受试者中发现了异常的BT结果。在7名（11.3%）CF患者和29名（7.4%）其他受试对象中，甲烷测量有助于SIBO的诊断。
小肠细菌过度生长在囊性纤维化中很常见。为了在囊性纤维化患者和其他胃肠道疾病患者中检测到SIBO，应采用联合测量氢气和甲烷，而不是氢呼气试验。如果不额外测量甲烷，将会漏诊相当一部分SIBO。
