小肠细菌过度生长与肝硬化预后不良相关。
Small Intestinal Bacterial Overgrowth Is Associated with Poor Prognosis in Cirrhosis.
作者信息
Efremova Irina, Maslennikov Roman, Alieva Aliya, Poluektova Elena, Ivashkin Vladimir
机构信息
Department of Internal Medicine, Gastroenterology and Hepatology, Sechenov University, 119121 Moscow, Russia.
The Interregional Public Organization "Scientific Community for the Promotion of the Clinical Study of the Human Microbiome", 119121 Moscow, Russia.
出版信息
Microorganisms. 2023 Apr 13;11(4):1017. doi: 10.3390/microorganisms11041017.
BACKGROUND
Small intestinal bacterial overgrowth (SIBO) is associated with numerous manifestations of cirrhosis. To determine whether the presence of SIBO affects the prognosis in cirrhosis was the aim of the study.
METHODS
This prospective cohort study included 50 patients. All participants underwent a lactulose hydrogen breath test for SIBO. The follow-up period was 4 years.
RESULTS
SIBO was detected in 26 (52.0%) patients: in 10 (52.6%) patients with compensated cirrhosis and in 16 (51.6%) ones with decompensated cirrhosis. Twelve (46.2%) patients with SIBO and four (16.7%) patients without SIBO died within 4 years ( = 0.009). Among patients with decompensated cirrhosis, 8 (50.0%) patients with SIBO and 3 (20.0%) patients without SIBO died ( = 0.027). Among patients with compensated cirrhosis, four (40.0%) patients with SIBO and one (11.1%) patient without SIBO died ( = 0.045). Among patients with SIBO, there was no difference in mortality between patients with compensated and decompensated cirrhosis ( = 0.209). It was the same for patients without SIBO ( = 0.215). SIBO affects the prognosis only in the first year of follow-up in decompensated cirrhosis, and only in subsequent years in compensated cirrhosis. Presence of SIBO ( = 0.028; HR = 4.2(1.2-14.9)) and serum albumin level ( = 0.027) were significant independent risk factors for death in cirrhosis.
CONCLUSIONS
SIBO is associated with poor prognosis in cirrhosis.
背景
小肠细菌过度生长（SIBO）与肝硬化的多种表现相关。本研究旨在确定SIBO的存在是否会影响肝硬化的预后。
方法
这项前瞻性队列研究纳入了50例患者。所有参与者均接受了用于检测SIBO的乳果糖氢呼气试验。随访期为4年。
结果
26例（52.0%）患者检测出SIBO：10例（52.6%）代偿期肝硬化患者和16例（51.6%）失代偿期肝硬化患者。12例（46.2%）SIBO患者和4例（16.7%）无SIBO患者在4年内死亡（P = 0.009）。在失代偿期肝硬化患者中，8例（50.0%）SIBO患者和3例（20.0%）无SIBO患者死亡（P = 0.027）。在代偿期肝硬化患者中，4例（40.0%）SIBO患者和1例（11.1%）无SIBO患者死亡（P = 0.045）。在SIBO患者中，代偿期和失代偿期肝硬化患者的死亡率无差异（P = 0.209）。无SIBO患者也是如此（P = 0.215）。SIBO仅在失代偿期肝硬化随访的第一年影响预后，而仅在代偿期肝硬化的后续年份影响预后。SIBO的存在（P = 0.028；HR = 4.2（1.2 - 14.9））和血清白蛋白水平（P = 0.027）是肝硬化患者死亡的重要独立危险因素。
结论
SIBO与肝硬化预后不良相关。
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