Del Zompo F, Ojetti V, Feliciani D, Mangiola F, Petruzziello C, Tesori V, Gaetani E, Gasbarrini A, Franceschi F
Gastroenterology Division and Internal Medicine Institute, Catholic University of the Sacred Hearth, School of Medicine, Gemelli Hospital Foundation, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2016 Aug;20(16):3452-6.
Despite a growing interest toward the interplay between H. pylori and gastric microbiota, few data are available about this correlation. The aim of this study was to explore the relationship between H. pylori infection and gas production during lactulose breath test.
Data of patients undergoing both 13C-urea breath test (UBT) and lactulose breath test (LBT) under standard conditions in our GI unit were retrospectively analyzed. GI symptoms, such as dyspepsia, bloating, abdominal pain/discomfort, and epigastric pain on an eleven-point scale were also analyzed and correlate with the results of those tests. H2 and CH4 were calculated using the trapezoidal rule; a considerable CH4 production was defined by AUCCH4 ≥1200 ppm*4h. Statistical analyses were performed with Fisher's exact test and independent samples Mann-Whitney test.
Data of 136 patients during a period of time of 3 months were analyzed. 36 patients (26.5%) showed a positive UBT. We do not find any difference as regards age, sex, symptom complaints, and small intestinal bacterial overgrowth between HP negative and positive patients. A greater methane production was observed in infected rather than non-infected patients (47.2% vs. 26% respectively, p=0.02). Furthermore, 25% infected and 10% non-infected produced greater amounts of CH4 compared to H2, resulting in a AUCCH4/AUCH2 ratio >1 (p=0.046).
This study shows for the first time, a significant association between H. pylori infection and methane production, suggesting that H. pylori might influence gut microbiota composition. Further studies are needed to clarify mechanisms underlying this phenomenon.
尽管人们对幽门螺杆菌与胃微生物群之间的相互作用越来越感兴趣，但关于这种相关性的数据却很少。本研究的目的是探讨幽门螺杆菌感染与乳果糖呼气试验期间产气之间的关系。
回顾性分析了在我们胃肠科接受标准条件下13C-尿素呼气试验（UBT）和乳果糖呼气试验（LBT）的患者的数据。还分析了消化不良、腹胀、腹痛/不适和上腹部疼痛等胃肠道症状，并根据11分制对这些症状进行评分，同时将这些症状与上述试验结果进行关联分析。使用梯形法则计算氢气和甲烷的含量；甲烷大量产生的定义为曲线下面积（AUC）CH4≥1200 ppm*4小时。采用Fisher精确检验和独立样本曼-惠特尼检验进行统计分析。
分析了136例患者在3个月期间的数据。36例患者（26.5%）UBT呈阳性。在幽门螺杆菌阴性和阳性患者之间，我们未发现年龄、性别、症状主诉和小肠细菌过度生长方面存在任何差异。在感染患者中观察到的甲烷产生量高于未感染患者（分别为47.2%和26%，p=0.02）。此外，与氢气相比，25%的感染患者和10%的未感染患者产生了更多的甲烷，导致AUCCH4/AUCH2比值>1（p=0.046）。
本研究首次表明幽门螺杆菌感染与甲烷产生之间存在显著关联，提示幽门螺杆菌可能影响肠道微生物群的组成。需要进一步研究来阐明这一现象背后的机制。
