甲烷氢呼气试验的临床应用进展
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摘要
近年兴起的甲烷氢呼气试验是一种诊断胃肠疾病及相关疾病的非侵入性方法。现回顾性分析甲烷氢呼气试验的相关文献,归纳其在临床应用方面的情况。总结甲烷氢呼气试验在诊断小肠细菌过度生长(small intestinal bacterial overgrowth,SIBO)、乳糖不耐受,以及大肠癌筛查中的作用。
Hydrogen and methane-based breath testing is an effectiveand non-invasive tool to diagnose gastrointestinal diseases and related diseases that has been developed in recent years. To conclude the the research progress of Hydrogen and methane-based breath testing in clinical application through reviewing and analyzing relevant literature in clinical application,it plays an important role in the test of the small intestinal bacterial overgrowth( SIBO),lactose intolerance and colorectal cancer screening. This article reviewed the clinical application of Hydrogen and methane-based breath testing.
Hydrogen and methane-based breath testing is an effectiveand non-invasive tool to diagnose gastrointestinal diseases and related diseases that has been developed in recent years. To conclude the the research progress of Hydrogen and methane-based breath testing in clinical application through reviewing and analyzing relevant literature in clinical application,it plays an important role in the test of the small intestinal bacterial overgrowth( SIBO),lactose intolerance and colorectal cancer screening. This article reviewed the clinical application of Hydrogen and methane-based breath testing.
引文
[1] REZAIE A,BURESI M,LEMBO A,et al. Hydrogen and methanebased breath testing in gastrointestinal disorders:the north american consensus[J]. Am J Gastroenterol,2017,112(5):775-784. DOI:10. 1038/ajg. 2017. 46.
[2] GASBARRINI A,CORAZZA G R,GASBARRINI G,et al. Methodology and indications of H2-breath testing in gastrointestinal diseases:the Rome Consensus Conference[J]. Aliment Pharmacol Ther,2009,29(Suppl1):1-49. DOI:10. 1111/j. 1365-2036. 2009. 03951. x.
[3] ALLIENDE F,VIAL C,ESPINOZA K,et al. Accuracy of a genetic test for the diagnosis of hypolactasia in chilean children:comparison with the breath test[J]. J Pediatr Gastroenterol Nutr,2016,63(1):e10-e13. DOI:10. 1097/MPG. 0000000000001208.
[4]李宁宁,王智凤,费贵军,等.氢气结合甲烷气呼气试验检测肠易激综合征患者小肠细菌过度生长[J].胃肠病学和肝病学杂志,2015,24(6):683-687. DOI:10. 3969/j. issn. 1006-5709. 2015. 06.012.LI N N,WANG Z F,FEI G J,et al. Measurement of methane and hydrogen in lactulose breath test on small intestinalbacterial overgrowth in patients with irritable bowel syndrome[J]. Chin J Gastroenterol Hepatol,2015,24(6):683-687. DOI:10. 3969/j. issn. 1006-5709. 2015. 06.012.
[5]张璐,王诗怡,范一宏,等.氢—甲烷气呼气试验在克罗恩病缓解期患者中的监测及意义研究[J].中华全科医学,2017,15(6):917-920. DOI:10. 16766/j. cnki. issn. 1674-4152. 2017. 06. 002.ZHANG L,WANG S Y,FAN Y H,et al. Detection and significance of hydrogen-methane breath test among Crohn disease patients in remission[J]. Chinese Journal of General Practice,2017,15(6):917-920. DOI:10. 16766/j. cnki. issn. 1674-4152. 2017. 06. 002.
[6] KUMAR K,GHOSHAL U C,SRIVASTAVA D,et al. Small intestinal bacterial overgrowth is common both among patients with alcoholic and idiopathic chronic pancreatitis[J]. Pancreatology,2014,14(4):280-283. DOI:10. 1016/j. pan. 2014. 05. 792.
[7] BODE C,KOLEPKE R,SCHFER K,et al. Breath hydrogen excretion in patients with alcoholic liver disease-evidence of small intestinal bacterial overgrowth[J]. Z Gastroenterol,1993,31(1):3-7.
[8]王为,周国华,冷明芳,等.酒精性肝病患者小肠细菌过度生长情况研究[J].中华临床医师杂志(电子版),2009,3(11):1914-1917. DOI:10. 3969/j. issn. 1674-0785. 2009. 11. 023.
[9] GHOSHAL U C,BABA C S,GHOSHAL U,et al. Low-grade small intestinal bacterial overgrowth is common in patients with non-alcoholic steatohepatitis on quantitative jejunal aspirate culture[J]. Indian J Gastroenterol,2017,36(5):390-399. DOI:10. 1007/s12664-017-0797-6.
[10]曹彬,丰义宽,李国庆.肝硬化患者小肠细菌过度生长与轻微肝性脑病的相关性研究[J].国际内科学杂志,2008,35(2):65-67.CAO B,FENG Y K,LI G Q. Research on relationship between small intestinal bacterial overgrowth and minimal hepatic encephalopathy in patients with cirrhosis[J]. International Journal of Internal Medicine,2008,35(2):65-67.
[11] CHANG C S,CHEN G H,LIEN H C,et al. Small intestine dysmotility and bacterial overgrowth in cirrhotic patients with spontaneous bacterial peritonitis[J]. Hepatology,1998,28(5):1187-1190.DOI:10. 1002/hep. 510280504.
[12] YANG C Y,CHANG C S,CHEN G H. Small-intestinal bacterial overgrowth in patients with liver cirrhosis,diagnosed with glucose H2or CH4 breath tests[J]. Scand J Gastroenterol,1998,33(8):867-871.
[13] HAMILTON L H. Breath tests and gastroenterology--a discussion of breath H2and breath CH4testing[M]. Quintron Division,the E. F.Brewer company Menomonee Falls,WI,USA. 1992,11-12,26-33,36-39,45-48,68-70.
[14] CHEU H W,BROWN D R,ROWE M I. Breath hydrogen excretion as a screening test for the early diagnosis of necrotizing enterocolitis[J]. Am J Dis Child,1989,143(2):156-159.
[15] KIM K M,KIM B T,LEE D J,et al. Erosive esophagitis may be related to small intestinal bacterial overgrowth[J]. Scand J Gastroenterol,2012,47(5):493-498. DOI:10. 3109/00365521.2012. 668932.
[16] GU L,DING C,TIAN H,et al. Serial frozen fecal microbiota transplantation in the treatment of chronic intestinal pseudo-obstruction:a preliminary study[J]. J Neurogastroenterol Motil,2017,23(2):289-297. DOI:10. 5056/jnm16074.
[17] PONZIANI F R,POMPILI M,DI STASIO E,et al. Subclinical atherosclerosis is linked to small intestinal bacterial overgrowth via vitamin K2-dependent mechanisms[J]. World J Gastroenterol,2017,23(7):1241-1249. DOI:10. 3748/wjg. v23. i7. 1241.
[18] FIALHO A,FIALHO A,SCHENONE A,et al. Association between small intestinal bacterial overgrowth and deep vein thrombosis[J].Gastroenterol Rep(Oxf),2016,4(4):299-303. DOI:10. 1093/gastro/gow004.
[19] RANA S,BHANSALI A,BHADADA S,et al. Orocecal transit time and small intestinal bacterial overgrowth in type 2 diabetes patients from North India[J]. Diabetes Technol Ther,2011,13(11):1115-1120. DOI:10. 1089/dia. 2011. 0078.
[20] PATIL A D. Link between hypothyroidism and small intestinal bacterial overgrowth[J]. Indian J Endocrinol Metab,2014,18(3):307-309. DOI:10. 4103/2230-8210. 131155.
[21] WANG L,YU Y M,ZHANG Y Q,et al. Hydrogen breath test to detect small intestinal bacterial overgrowth:a prevalence case-control study in autism[J]. Eur Child Adolesc Psychiatry,2018,27(2):233-240. DOI:10. 1007/s00787-017-1039-2.
[22] JO J H,PARK S J,CHEON J H,et al. Rediscover the clinical value of small intestinal bacterial overgrowth in patients with intestinal Behcet’s disease[J]. J Gastroenterol Hepatol,2018,33(2):375-379.DOI:10. 1111/jgh. 13855.
[23] ADARSH M B,SHARMA S K,SINHA S K,et al. Gastrointestinal dysmotility and infections in systemic sclerosis-an Indian Scenario[J].Curr Rheumatol Rev, 2018, 14(2):172-176. DOI:10.2174/1573397113666170425145405.
[24] ZHANG Y,LIU G,DUAN Y,et al. Prevalence of small intestinal bacterial overgrowth in multiple sclerosis:a case-control study from China[J]. J Neuroimmunol,2016,15,301:83-87. DOI:10.1016/j. jneuroim. 2016. 11. 004.
[25] NIU X L,LIU L,SONG Z X,et al. Prevalence of small intestinal bacterial overgrowth in Chinese patients with Parkinson’s disease[J]. J Neural Transm(Vienna),2016,123(12):1381-1386. DOI:10.1007/s00702-016-1612-8.
[26] KIM D B,PAIK C N,KIM Y J,et al. Positive glucose breath tests in patients with hysterectomy,gastrectomy,and cholecystectomy[J].Gut Liver,2017,11(2):237-242. DOI:10. 5009/gnl16132.
[27] DENG L,LIU Y,ZHANG D,et al. Prevalence and treatment of small intestinal bacterial overgrowth in postoperative patients with colorectal cancer[J]. Mol Clin Oncol,2016,4(5):883-887.DOI:10. 3892/mco. 2016. 807.
[28] HENEGHAN H M,ZABOROWSKI A,FANNING M,et al. Prospective study of malabsorption and malnutrition after esophageal and gastric cancer surgery[J]. Ann Surg,2015,262(5):803-807,discussion 807-808. DOI:10. 1097/SLA. 0000000000001445.
[29] WEINSTOCK L B,STEINHOFF M. Rosacea and small intestinal bacterial overgrowth:prevalence and response to rifaximin[J]. J Am Acad Dermatol,2013,68(5):875-876. DOI:10. 1016/j. jaad.2012. 11. 038.
[30] US Cancer Statistics Working Group. United States Cancer Statistics(USCS):1999-2008 incidence and mortality data[R/OL]. Atlanta:Department of Health and Human Services,CDC,National Cancer Institute(2010)Available:http://apps. nccd. cdc. gov/uscs/. Accessed2013 Nov.
[31] HAINES A,METZ G,DILAWARI J,et al. Breath-methane in patients with cancer of the large bowel[J]. Lancet,1977,2(8036):481-483.
[32]张丽冬,陈达民,张达荣,等.甲烷呼气试验和粪便隐血试验对大肠癌诊断价值的评析[J].上海医学,1994,17(8):478,454.
[2] GASBARRINI A,CORAZZA G R,GASBARRINI G,et al. Methodology and indications of H2-breath testing in gastrointestinal diseases:the Rome Consensus Conference[J]. Aliment Pharmacol Ther,2009,29(Suppl1):1-49. DOI:10. 1111/j. 1365-2036. 2009. 03951. x.
[3] ALLIENDE F,VIAL C,ESPINOZA K,et al. Accuracy of a genetic test for the diagnosis of hypolactasia in chilean children:comparison with the breath test[J]. J Pediatr Gastroenterol Nutr,2016,63(1):e10-e13. DOI:10. 1097/MPG. 0000000000001208.
[4]李宁宁,王智凤,费贵军,等.氢气结合甲烷气呼气试验检测肠易激综合征患者小肠细菌过度生长[J].胃肠病学和肝病学杂志,2015,24(6):683-687. DOI:10. 3969/j. issn. 1006-5709. 2015. 06.012.LI N N,WANG Z F,FEI G J,et al. Measurement of methane and hydrogen in lactulose breath test on small intestinalbacterial overgrowth in patients with irritable bowel syndrome[J]. Chin J Gastroenterol Hepatol,2015,24(6):683-687. DOI:10. 3969/j. issn. 1006-5709. 2015. 06.012.
[5]张璐,王诗怡,范一宏,等.氢—甲烷气呼气试验在克罗恩病缓解期患者中的监测及意义研究[J].中华全科医学,2017,15(6):917-920. DOI:10. 16766/j. cnki. issn. 1674-4152. 2017. 06. 002.ZHANG L,WANG S Y,FAN Y H,et al. Detection and significance of hydrogen-methane breath test among Crohn disease patients in remission[J]. Chinese Journal of General Practice,2017,15(6):917-920. DOI:10. 16766/j. cnki. issn. 1674-4152. 2017. 06. 002.
[6] KUMAR K,GHOSHAL U C,SRIVASTAVA D,et al. Small intestinal bacterial overgrowth is common both among patients with alcoholic and idiopathic chronic pancreatitis[J]. Pancreatology,2014,14(4):280-283. DOI:10. 1016/j. pan. 2014. 05. 792.
[7] BODE C,KOLEPKE R,SCHFER K,et al. Breath hydrogen excretion in patients with alcoholic liver disease-evidence of small intestinal bacterial overgrowth[J]. Z Gastroenterol,1993,31(1):3-7.
[8]王为,周国华,冷明芳,等.酒精性肝病患者小肠细菌过度生长情况研究[J].中华临床医师杂志(电子版),2009,3(11):1914-1917. DOI:10. 3969/j. issn. 1674-0785. 2009. 11. 023.
[9] GHOSHAL U C,BABA C S,GHOSHAL U,et al. Low-grade small intestinal bacterial overgrowth is common in patients with non-alcoholic steatohepatitis on quantitative jejunal aspirate culture[J]. Indian J Gastroenterol,2017,36(5):390-399. DOI:10. 1007/s12664-017-0797-6.
[10]曹彬,丰义宽,李国庆.肝硬化患者小肠细菌过度生长与轻微肝性脑病的相关性研究[J].国际内科学杂志,2008,35(2):65-67.CAO B,FENG Y K,LI G Q. Research on relationship between small intestinal bacterial overgrowth and minimal hepatic encephalopathy in patients with cirrhosis[J]. International Journal of Internal Medicine,2008,35(2):65-67.
[11] CHANG C S,CHEN G H,LIEN H C,et al. Small intestine dysmotility and bacterial overgrowth in cirrhotic patients with spontaneous bacterial peritonitis[J]. Hepatology,1998,28(5):1187-1190.DOI:10. 1002/hep. 510280504.
[12] YANG C Y,CHANG C S,CHEN G H. Small-intestinal bacterial overgrowth in patients with liver cirrhosis,diagnosed with glucose H2or CH4 breath tests[J]. Scand J Gastroenterol,1998,33(8):867-871.
[13] HAMILTON L H. Breath tests and gastroenterology--a discussion of breath H2and breath CH4testing[M]. Quintron Division,the E. F.Brewer company Menomonee Falls,WI,USA. 1992,11-12,26-33,36-39,45-48,68-70.
[14] CHEU H W,BROWN D R,ROWE M I. Breath hydrogen excretion as a screening test for the early diagnosis of necrotizing enterocolitis[J]. Am J Dis Child,1989,143(2):156-159.
[15] KIM K M,KIM B T,LEE D J,et al. Erosive esophagitis may be related to small intestinal bacterial overgrowth[J]. Scand J Gastroenterol,2012,47(5):493-498. DOI:10. 3109/00365521.2012. 668932.
[16] GU L,DING C,TIAN H,et al. Serial frozen fecal microbiota transplantation in the treatment of chronic intestinal pseudo-obstruction:a preliminary study[J]. J Neurogastroenterol Motil,2017,23(2):289-297. DOI:10. 5056/jnm16074.
[17] PONZIANI F R,POMPILI M,DI STASIO E,et al. Subclinical atherosclerosis is linked to small intestinal bacterial overgrowth via vitamin K2-dependent mechanisms[J]. World J Gastroenterol,2017,23(7):1241-1249. DOI:10. 3748/wjg. v23. i7. 1241.
[18] FIALHO A,FIALHO A,SCHENONE A,et al. Association between small intestinal bacterial overgrowth and deep vein thrombosis[J].Gastroenterol Rep(Oxf),2016,4(4):299-303. DOI:10. 1093/gastro/gow004.
[19] RANA S,BHANSALI A,BHADADA S,et al. Orocecal transit time and small intestinal bacterial overgrowth in type 2 diabetes patients from North India[J]. Diabetes Technol Ther,2011,13(11):1115-1120. DOI:10. 1089/dia. 2011. 0078.
[20] PATIL A D. Link between hypothyroidism and small intestinal bacterial overgrowth[J]. Indian J Endocrinol Metab,2014,18(3):307-309. DOI:10. 4103/2230-8210. 131155.
[21] WANG L,YU Y M,ZHANG Y Q,et al. Hydrogen breath test to detect small intestinal bacterial overgrowth:a prevalence case-control study in autism[J]. Eur Child Adolesc Psychiatry,2018,27(2):233-240. DOI:10. 1007/s00787-017-1039-2.
[22] JO J H,PARK S J,CHEON J H,et al. Rediscover the clinical value of small intestinal bacterial overgrowth in patients with intestinal Behcet’s disease[J]. J Gastroenterol Hepatol,2018,33(2):375-379.DOI:10. 1111/jgh. 13855.
[23] ADARSH M B,SHARMA S K,SINHA S K,et al. Gastrointestinal dysmotility and infections in systemic sclerosis-an Indian Scenario[J].Curr Rheumatol Rev, 2018, 14(2):172-176. DOI:10.2174/1573397113666170425145405.
[24] ZHANG Y,LIU G,DUAN Y,et al. Prevalence of small intestinal bacterial overgrowth in multiple sclerosis:a case-control study from China[J]. J Neuroimmunol,2016,15,301:83-87. DOI:10.1016/j. jneuroim. 2016. 11. 004.
[25] NIU X L,LIU L,SONG Z X,et al. Prevalence of small intestinal bacterial overgrowth in Chinese patients with Parkinson’s disease[J]. J Neural Transm(Vienna),2016,123(12):1381-1386. DOI:10.1007/s00702-016-1612-8.
[26] KIM D B,PAIK C N,KIM Y J,et al. Positive glucose breath tests in patients with hysterectomy,gastrectomy,and cholecystectomy[J].Gut Liver,2017,11(2):237-242. DOI:10. 5009/gnl16132.
[27] DENG L,LIU Y,ZHANG D,et al. Prevalence and treatment of small intestinal bacterial overgrowth in postoperative patients with colorectal cancer[J]. Mol Clin Oncol,2016,4(5):883-887.DOI:10. 3892/mco. 2016. 807.
[28] HENEGHAN H M,ZABOROWSKI A,FANNING M,et al. Prospective study of malabsorption and malnutrition after esophageal and gastric cancer surgery[J]. Ann Surg,2015,262(5):803-807,discussion 807-808. DOI:10. 1097/SLA. 0000000000001445.
[29] WEINSTOCK L B,STEINHOFF M. Rosacea and small intestinal bacterial overgrowth:prevalence and response to rifaximin[J]. J Am Acad Dermatol,2013,68(5):875-876. DOI:10. 1016/j. jaad.2012. 11. 038.
[30] US Cancer Statistics Working Group. United States Cancer Statistics(USCS):1999-2008 incidence and mortality data[R/OL]. Atlanta:Department of Health and Human Services,CDC,National Cancer Institute(2010)Available:http://apps. nccd. cdc. gov/uscs/. Accessed2013 Nov.
[31] HAINES A,METZ G,DILAWARI J,et al. Breath-methane in patients with cancer of the large bowel[J]. Lancet,1977,2(8036):481-483.
[32]张丽冬,陈达民,张达荣,等.甲烷呼气试验和粪便隐血试验对大肠癌诊断价值的评析[J].上海医学,1994,17(8):478,454.