Department of Pediatrics, Cangzhou Central Hospital, No. 16, Xinhua West Road, Cangzhou, 061000, Hebei, China.
Department of Pediatrics, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
Eur Child Adolesc Psychiatry. 2018 Feb;27(2):233-240. doi: 10.1007/s00787-017-1039-2. Epub 2017 Aug 10.
The aim of this study is to assess the prevalence of small intestinal bacterial overgrowth (SIBO) by hydrogen breath test in patients with autism spectrum disorders (ASD) with respect to a consistent control group. From 2011 to 2013, 310 children with ASD and 1240 sex- and age-matched typical children were enrolled in this study to undergo glucose breath test. The study participants were considered to exhibit SIBO when an increase in H of ≥20 ppm or CH of ≥10 ppm with respect to the fasting value was observed up to 60 min after the ingestion of glucose. Ninety-six children with autism suffered from SIBO, giving a prevalence rate of SIBO was 31.0% (95% CI 25.8-36.1%). In contrast, 9.3% of the typical children acknowledged SIBO. The difference between groups was statistically significant (P < 0.0001). The median Autism Treatment Evaluation Checklist (ATEC) score in the children with autism and with SIBO was significantly high when compared with the children without autism and without SIBO [98 (IQR, 45-120) vs. 63 (32-94), P < 0.001]. For the autism group, the 6-GI Severity Index (6-GSI) score was found to be strongly and significantly correlated with the total ATEC score (r = 0.639, P < 0.0001). SIBO was significantly associated with worse symptoms of autism, demonstrating that children with SIBO may significantly contribute to symptoms of autism.
本研究旨在通过氢呼气试验评估自闭症谱系障碍（ASD）患者小肠细菌过度生长（SIBO）的患病率，并与一致的对照组进行比较。2011 年至 2013 年，纳入了 310 名 ASD 儿童和 1240 名性别和年龄匹配的典型儿童进行葡萄糖呼气试验。研究参与者被认为存在 SIBO，如果在摄入葡萄糖后 60 分钟内，氢（H）增加≥20 ppm 或 CH 增加≥10 ppm，与空腹值相比。96 名自闭症儿童患有 SIBO，患病率为 31.0%（95%CI 25.8-36.1%）。相比之下，9.3%的典型儿童患有 SIBO。两组之间的差异具有统计学意义（P < 0.0001）。患有自闭症和 SIBO 的儿童的自闭症治疗评估检查表（ATEC）评分中位数明显高于没有自闭症和没有 SIBO 的儿童[98（IQR，45-120）比 63（32-94），P < 0.001]。对于自闭症组，6-GI 严重程度指数（6-GSI）评分与总 ATEC 评分呈强显著相关（r = 0.639，P < 0.0001）。SIBO 与自闭症症状显著相关，表明 SIBO 患儿可能显著加重自闭症症状。
