Sarno S, Erasmus L P, Haslbeck M, Hölzl R
Klinische Psychologie, Universität Mannheim, Germany.
Ital J Gastroenterol. 1993 Feb-Mar;25(2):55-64.
The study compares common variants of the hydrogen breath test to measure oroceacal transit time under different conditions. Definition of caecal entry point rather than procedural parameters were found to be a main variable influencing the test results. Visual assessment still seemed to be the most reliable and valid technique. To overcome its subjectivity and evaluator-dependency, a comprehensive set of rules simulating implicit criteria of expert physicians was defined and compared with commonly used caecal entry assessment rules. Results indicated that: 1) using visual assessment, experts produce highly consistent CE points; 2) caecal entries by the new rule set correlate highly with them, while previously published caecal entry detection methods were poorly correlated with visual assessment; 3) using a semiliquid test meal reduced reliability of all methods, but the new method remained superior; 4) earlier caecal entry detection methods failed completely when early peaks or baseline fluctuations were present; 5) detection of H2 non-producers and of bacterial overgrowth was much more difficult with classical caecal entry definitions than with the new rule-set.
该研究比较了氢呼气试验的常见变体，以测量不同条件下的口盲肠转运时间。结果发现，盲肠进入点的定义而非操作参数是影响测试结果的主要变量。视觉评估似乎仍是最可靠、有效的技术。为克服其主观性和评估者依赖性，定义了一套模拟专家医生隐含标准的综合规则，并与常用的盲肠进入评估规则进行比较。结果表明：1）使用视觉评估时，专家得出的盲肠进入点高度一致；2）新规则集确定的盲肠进入点与之高度相关，而此前发表的盲肠进入检测方法与视觉评估的相关性较差；3）使用半流质测试餐会降低所有方法的可靠性，但新方法仍更具优势；4）当出现早期峰值或基线波动时，早期盲肠进入检测方法完全失效；5）与新规则集相比，经典盲肠进入定义对非氢气产生者和细菌过度生长的检测要困难得多。
