DETECTION OF MALABSORPTION OF LOW-DOSES OF CARBOHYDRATE - ACCURACY OF VARIOUS BREATH H2 CRITERIA
DETECTION OF MALABSORPTION OF LOW-DOSES OF CARBOHYDRATE - ACCURACY OF VARIOUS BREATH H2 CRITERIA
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DOI：
10.1016/0016-5085(93)90145-3
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发表时间：
1993-11-01
期刊：
影响因子：
29.4
通讯作者：
LEVITT, MD
中科院分区：
文献类型：
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作者：
STROCCHI, A;CORAZZA, G;LEVITT, MD
背景资料：虽然呼气H2测试检测小剂量（< 50 g）碳水化合物吸收不良的准确性从未被评估过，但研究表明，其准确性受到“H2非生产者”高患病率的限制。本研究的目的是确定10克碳水化合物的吸收不良的检测的准确性H2呼气测试。研究方法：在55名健康受试者中，我们确定了呼吸H 2测量的能力，以区分摄入10克不可吸收的碳水化合物（乳果糖）和两种对照餐，不可吸收的电解质溶液或葡萄糖（10克）。结果如下：呼吸H2增加20 ppm的常规标准具有100%的特异性，但在4小时和8小时的测试中，47%和24%的受试者未能识别乳果糖吸收不良。相比之下，5或6小时呼吸H2> 6ppm具有接近完美的特异性和灵敏度。在5、6和7小时的呼吸H2总和> 15 ppm，在乳果糖和对照溶液之间产生完美的分离。结论：真正的“H2非生产者”是极其罕见的.使用适当的标准，呼气H2测试提供了一个非常准确的方法来识别低剂量碳水化合物的吸收不良。
Background: Although the accuracy of breath H 2 testing to detect malabsorption of small (< 50 g) doses of carbohydrate has never been evaluated, studies suggest that its accuracy is limited by a high prevalence of “H 2 nonproducers.” The aim of this study was to determine the accuracy of H 2 breath testing in the detection of malabsorption of 10 g of carbohydrate. Methods: In 55 healthy subjects, we determined the ability of breath H 2 measurements to distinguish between the ingestion of 10 g of a nonabsorbable carbohydrate (lactulose) and two control meals, a nonabsorbable electrolyte solution or glucose (10 g). Results: The conventional criterion of a 20 ppm increase in breath H 2 had 100% specificity but failed to identify lactulose malabsorption in 47% and 24% of subjects at 4 and 8 hours of testing. In contrast, a breath H 2 of> 6 ppm at 5 or 6 hours had near perfect specificity and sensitivity. A sum of breath H 2 at 5, 6, and 7 hours of> 15 ppm yielded perfect separation between lactulose and control solutions. Conclusions: True “H 2 nonproducers” are extremely rare. Using appropriate criteria, breath H 2 testing provides a very accurate means of identifying malabsorption of low doses of carbohydrate.