Cheu H W, Brown D R, Rowe M I
Department of Surgery, Children's Hospital of Pittsburgh, PA.
Am J Dis Child. 1989 Feb;143(2):156-9. doi: 10.1001/archpedi.1989.02150140042017.
We measured breath H2 excretion in 122 neonates from birth to 1 month of age. The patients weighed less than 2000 g at birth and thus were at risk for developing necrotizing enterocolitis (NEC). Hydrogen excretion was normalized for the quality of the expired air by dividing by the carbon dioxide pressure of the gas sample. The mean (+/- SD) peak H2/CO2 ratio was significantly different between the seven patients who subsequently developed NEC (9.4 +/- 2.7 ppm/mm Hg) and the 115 patients who did not (5.0 +/- 3.5 ppm/mm Hg). The prevalence of NEC was 5.7% in the present study. Defining a positive test as one with a ratio value of greater than or equal to 8.0 ppm/mm Hg, the resulting screening test had a sensitivity of 86% and a specificity of 90%. The screening test yielded a 33% predictive value of a positive test and a 99% predictive value of a negative test. High H2 excretion occurred eight to 28 hours before the earliest clinical signs of NEC. Breath H2 excretion is a simple noninvasive test that may be useful in the management of the premature neonate at risk for the development of NEC.
我们对122名新生儿从出生到1月龄期间的呼气氢气排泄情况进行了测量。这些患儿出生时体重不足2000克，因此有发生坏死性小肠结肠炎（NEC）的风险。通过用气体样本的二氧化碳分压除氢气排泄量，对呼出气体质量进行了标准化处理。在随后发生NEC的7名患儿（9.4±2.7 ppm/mm Hg）与未发生NEC的115名患儿（5.0±3.5 ppm/mm Hg）之间，平均（±标准差）峰值H2/CO2比值存在显著差异。在本研究中，NEC的患病率为5.7%。将比值大于或等于8.0 ppm/mm Hg的检测定义为阳性检测，所得筛查试验的敏感性为86%，特异性为90%。该筛查试验的阳性预测值为33%，阴性预测值为99%。在NEC最早临床体征出现前8至28小时出现氢气排泄量升高。呼气氢气排泄是一项简单的非侵入性检测，可能有助于对有发生NEC风险的早产儿进行管理。
