Small intestinal bacterial overgrowth in patients with cirrhosis:: Prevalence and relation with spontaneous bacterial peritonitis
Small intestinal bacterial overgrowth in patients with cirrhosis:: Prevalence and relation with spontaneous bacterial peritonitis
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DOI：
10.1111/j.1572-0241.2001.04668.x
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发表时间：
2001-10-01
影响因子：
9.8
通讯作者：
Blum, HE
中科院分区：
文献类型：
--
作者：
Bauer, TM;Steinbrückner, B;Blum, HE
目的：肝硬化患者小肠细菌过度生长的意义尚不完全清楚，其诊断标准也不统一。我们研究了小肠细菌过度生长与自发性细菌性腹膜炎的关系，并比较了各种微生物标准。方法：对70例肝硬化患者空肠分泌物进行定量培养，并按不同定义进行分类。在1年的随访中，评估患者的临床特征并监测自发性细菌性腹膜炎的发生率。结果：61%的患者存在小肠细菌过度生长，定义为大于或等于10(5)个总集落形成单位/ml空肠分泌物。小肠细菌过度生长与抑酸治疗（p = 0.01）和次氯酸血症（p < 0.001）相关。对29例持续性腹水患者进行了观察。平均12.8周后发生6次自发性细菌性腹膜炎。自发性细菌性腹膜炎的发生与腹水蛋白浓度（p = 0.01）和血清胆红素（p = 0.04）相关，但与小肠细菌过度生长无关（p = 0.39）。其与抑酸治疗的相关性具有临界显著性（风险比= 7.0,p = 0.08）。结论：肝硬化患者的小肠细菌过度生长与抑酸治疗和次氯酸有关，但与自发性细菌性腹膜炎无关。抑酸治疗在自发性细菌性腹膜炎发病机制中的潜在作用值得进一步研究。[J] .中华胃肠病杂志，2001;26(2):362 - 367。(C) 2001由Am。科尔。胃肠病学)。
OBJECTIVES: The significance of small intestinal bacterial overgrowth in patients with cirrhosis is not fully understood and its diagnostic criteria are not uniform. We examined the association of small intestinal bacterial overgrowth with spontaneous bacterial peritonitis and compared various microbiological criteria.METHODS: Jejunal secretions from 70 patients with cirrhosis were cultivated quantitatively and classified according to various definitions. Clinical characteristics of patients were evaluated and the incidence of spontaneous bacterial peritonitis was monitored during a 1-yr follow-up.RESULTS: Small intestinal bacterial overgrowth, defined as greater than or equal to 10(5) total colony-forming units/ml jejunal secretions, was present in 61% of patients. Small intestinal bacterial overgrowth was associated with acid-suppressive therapy (p = 0.01) and hypochlorhydria (p < 0.001). Twenty-nine patients with persistent ascites were observed. Six episodes of spontaneous bacterial peritonitis occurred after an average 12.8 wk. Occurrence of spontaneous bacterial peritonitis correlated with ascitic fluid protein concentration (p = 0.01) and serum bilirubin (p = 0.04) but not with small intestinal bacterial overgrowth (p = 0.39). Its association with acid-suppressive therapy was of borderline significance (hazard ratio = 7.0, p = 0.08).CONCLUSIONS: Small intestinal bacterial overgrowth in cirrhotic patients is associated with acid-suppressive therapy and hypochlorhydria, but not with spontaneous bacterial peritonitis. The potential role of acid-suppressive therapy in the pathogenesis of spontaneous bacterial peritonitis merits further studies. (Am J Gastroenterol 2001;96:2962-2967. (C) 2001 by Am. Coll. of Gastroenterology).