Rumessen J J, Nordgaard-Andersen I, Gudmand-Høyer E
Dept. of Internal Medicine and Gastroenterology F, Gentofte Hospital, University of Copenhagen, Denmark.
Scand J Gastroenterol. 1994 Sep;29(9):826-32. doi: 10.3109/00365529409092518.
Previous studies in small series of healthy adults have suggested that parallel measurement of hydrogen and methane resulting from gut fermentation may improve the precision of quantitative estimates of carbohydrate malabsorption. Systematic, controlled studies of the role of simultaneous hydrogen and methane measurements using end-expiratory breath test techniques are not available.
We studied seven healthy, adult methane and hydrogen producers and seven methane non-producers by means of end-expiratory breath test techniques. Breath gas concentrations and gastrointestinal symptoms were recorded at intervals for 12h after ingestion of 10, 20 and 30 g lactulose.
In the seven methane producers the excretion pattern was highly variable; the integrated methane responses were disproportional and not reliably reproducible. However, quantitative estimates of carbohydrate malabsorption on the basis of individual areas under the methane and hydrogen excretion curves (AUCs) tended to improve in methane producers after ingestion of 20 g lactulose by simple addition of AUCs of methane to the AUCs of the hydrogen curves. Estimates were no more precise in methane producers than similar estimates in non-producers. Gastrointestinal symptoms increased significantly with increasing lactulose dose; correlation with total hydrogen and methane excretion was weak.
Our study suggests that in methane producers, simple addition of methane and hydrogen excretion improves the precision of semiquantitative measurements of carbohydrate malabsorption. The status of methane production should, therefore, be known to interpret breath tests semiquantitatively. The weak correlation between hydrogen and methane excretion and gas-related abdominal complaints suggests that other factors than net production of these gases may be responsible for the symptoms.
先前针对一小部分健康成年人的研究表明，对肠道发酵产生的氢气和甲烷进行平行测量，可能会提高碳水化合物吸收不良定量估计的精确度。目前尚无使用呼气末呼吸测试技术同时测量氢气和甲烷作用的系统对照研究。
我们通过呼气末呼吸测试技术对7名健康的成年甲烷和氢气产生者以及7名非甲烷产生者进行了研究。在摄入10克、20克和30克乳果糖后，每隔一段时间记录呼气中气体浓度和胃肠道症状，持续12小时。
在7名甲烷产生者中，排泄模式高度可变；累积甲烷反应不成比例且无法可靠重现。然而，在摄入20克乳果糖后，通过简单地将甲烷曲线下面积（AUC）与氢气曲线下面积相加，甲烷产生者基于甲烷和氢气排泄曲线下各个面积（AUC）对碳水化合物吸收不良的定量估计往往有所改善。甲烷产生者的估计并不比非产生者的类似估计更精确。胃肠道症状随乳果糖剂量增加而显著增加；与总氢气和甲烷排泄的相关性较弱。
我们的研究表明，对于甲烷产生者，简单地将甲烷和氢气排泄量相加可提高碳水化合物吸收不良半定量测量的精确度。因此，为了对半定量解释呼气测试结果，应该了解甲烷产生情况。氢气和甲烷排泄与气体相关腹部不适之间的弱相关性表明，这些气体的净产生量以外的其他因素可能导致了这些症状。
