Role of small intestinal bacterial overgrowth in severe small intestinal damage in chronic non-steroidal anti-inflammatory drug users
Role of small intestinal bacterial overgrowth in severe small intestinal damage in chronic non-steroidal anti-inflammatory drug users
复制标题
DOI：
10.3109/00365521.2014.880182
复制
发表时间：
2014-03-01
影响因子：
1.9
通讯作者：
Arakawa, Tetsuo
中科院分区：
文献类型：
--
作者：
Muraki, Motoko;Fujiwara, Yasuhiro;Arakawa, Tetsuo
客观的。肠道细菌在非甾体抗炎药（NSAID）引起的小肠损伤的发病机制中发挥着重要作用。然而，小肠细菌过度生长（SIBO）与 NSAID 引起的小肠损伤之间的关系仍不清楚。该研究的目的是检查 SIBO 与长期 NSAID 使用者中 NSAID 引起的严重小肠损伤或其症状之间的关系。材料和方法。入组了 43 名使用 NSAIDs 超过 3 个月的患者。他们接受了胶囊内窥镜检查和乳果糖氢呼气试验（LHBT）检查。我们将严重的小肠损伤定义为存在四个以上的小糜烂或大糜烂/溃疡。如果呼吸氢气水平比基线增加 > 20 ppm，则 LHBT 结果被视为阳性。结果。 43 名患者中，22 名（51%）患有严重的小肠损伤。 21 名无严重小肠损伤的患者中有 5 名 (24%) LHBT 呈阳性，21 名有严重小肠损伤的患者中有 13 名 (59%) LHBT 呈阳性。多元逻辑回归分析显示，LHBT 阳性结果与严重小肠损伤的比值比增加显着相关（OR，6.54；95% CI，1.40-30.50）。 LHBT阳性和LHBT阴性的严重小肠损伤患者的症状存在无显着差异。结论。 SIBO 可能与长期使用非甾体抗炎药的人出现严重小肠损伤有关。
Objective. Enteric bacteria play a significant role in the pathogenesis of non-steroidal anti-inflammatory drug (NSAID)induced small intestinal damage. However, the association between small intestinal bacterial overgrowth (SIBO) and NSAID-induced small intestinal damage remains unclear. The aim of the study was to examine the association between SIBO and the presence of NSAID-induced severe small intestinal damage or its symptoms in chronic NSAID users. Materials and methods. Forty-three patients who had been using NSAIDs for over 3 months were enrolled. They were examined by capsule endoscopy and a lactulose hydrogen breath test (LHBT). We defined severe small intestinal damage as the presence of more than four small erosions or large erosions/ulcers. The LHBT result was considered positive if there was an increase in the level of breath hydrogen gas of >20 ppm above baseline. Results. Out of 43 patients, 22 (51%) had severe small intestinal damage. The LHBT was positive in 5 of 21 patients (24%) without severe small intestinal damage and in 13 of 21 patients (59%) with severe small intestinal damage. Multiple logistic regression analysis showed that an LHBT-positive result was significantly associated with increased odds ratio for severe small intestinal damage (OR, 6.54; 95% CI, 1.40-30.50). There was no significant difference in the presence of symptoms between the LHBT-positive and LHBT-negative patients with severe small intestinal damage. Conclusion. SIBO might have a role in the development of severe small intestinal damage in chronic NSAID users.