呼气氢浓度增加与主胰管狭窄相关。

Increase in breath hydrogen concentration was correlated with the main pancreatic duct stenosis.

机构信息

Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

出版信息

J Breath Res. 2018 Mar 12;12(3):036004. doi: 10.1088/1752-7163/aaaf77.

DOI:10.1088/1752-7163/aaaf77

PMID:29445052

Abstract

BACKGROUND

Hydrogen is produced from unabsorbed carbohydrates in the intestine through degradation and metabolism by hydrogenase of intestinal bacteria. The hydrogen is then partially diffused into blood flow and released and detected in exhaled breath. Pancreatic juice production is decreased in patients with reduced pancreatic exocrine function, including those with pancreatic cancer, thus decreasing digestion and absorption of nutrients including carbohydrates, which may increase undigested carbohydrates in the intestine and increase breath hydrogen concentration (BHC). The aim of this study was to investigate the association between BHC and pancreatic diseases.

METHODS

A retrospective study was designed and 68 patients underwent morning fasting breath hydrogen test. Since there is no clear standard, normal BHC, the median of the measured values from the subjects (9 ppm) was adopted as the standard. The subjects were classified into those with a value exceeding the median (BHC high group: 32 patients) and a value equal to or below the median (BHC low group: 36 patients). Patients characteristics, blood test results and imaging findings characteristic of pancreatic diseases were compared between the groups.

RESULTS

The age was significantly higher (P = 0.010) and the incidences of pancreatic ductal adenocarcinoma and autoimmune pancreatitis were significantly higher (P = 0.018 and P = 0.004, respectively) in the BHC high group. With respect to the blood test items, the Alb level was significantly lower in the BHC high group (P = 0.005). With respect to the characteristic imaging findings of pancreatic diseases, the proportions of patients with pancreatic enlargement, the main pancreatic duct (MPD) stenosis, and the MPD dilatation were significantly higher in the BHC high group (P = 0.022, P < 0.001, and P = 0.002, respectively). On univariate analysis, only the MPD stenosis was extracted as an independent factor (P = 0.014).

CONCLUSION

It was suggested that the fasting BHC is associated with pancreatic diseases causing stenosis of the MPD, including pancreatic cancer (UMIN000020777).

摘要

背景

氢气是通过肠道细菌的氢酶对未被吸收的碳水化合物进行降解和代谢而产生的。然后，部分氢气扩散到血流中，并在呼出的气体中释放和检测到。患有胰腺外分泌功能减退的患者（包括胰腺癌患者）的胰腺液分泌减少，从而减少了包括碳水化合物在内的营养物质的消化和吸收，这可能会增加肠道中未消化的碳水化合物，并增加呼气氢气浓度（BHC）。本研究旨在探讨 BHC 与胰腺疾病之间的关系。

方法

设计了一项回顾性研究，共有 68 名患者接受了空腹呼吸氢气测试。由于没有明确的标准，采用测量值中位数（9ppm）作为正常 BHC 的标准。将受试者分为超过中位数（BHC 高组：32 例）和等于或低于中位数（BHC 低组：36 例）的两组。比较两组患者的特征、血液检查结果和胰腺疾病的影像学特征。

结果

BHC 高组的年龄明显较高（P=0.010），胰腺导管腺癌和自身免疫性胰腺炎的发生率明显较高（P=0.018 和 P=0.004）。在血液检查项目中，BHC 高组的 Alb 水平明显较低（P=0.005）。在胰腺疾病的特征性影像学表现方面，BHC 高组患者胰腺增大、主胰管（MPD）狭窄和 MPD 扩张的比例明显较高（P=0.022、P<0.001 和 P=0.002）。单因素分析显示，只有 MPD 狭窄被提取为独立因素（P=0.014）。