JAHA:小肠细菌过度生长与心力衰竭的关系及其对患者短期结局的预测

2021-03-18 MedSci原创 MedSci原创

心力衰竭患者中SIBO的患病率很高,而且SIBO与患者不良预后独立相关。积极的SIBO治疗可以为心衰患者提供额外的益处。

小肠细菌过度生长(SIBO)是一种常见的肠道菌群病理状态。SIBO的患病率及其在心力衰竭(HF)患者中的预后价值尚未明确。

近日,葛均波院士团队在血管疾病领域权威杂志JAHA上发表了一篇研究文章,他们使用乳果糖氢-甲烷呼气试验对287例患者的SIBO进行了评估。

至少满足以下标准中的1项为SIBO阳性:空腹氢水平≥20ppm (ppm)或90分钟内氢升高≥20ppm的患者诊断为SIBO (H2)阳性;随机检测甲烷水平≥10ppm的患者被诊断为SIBO (CH4)阳性。研究人员分析了SIBO与心血管死亡和心衰再住院复合结局之间的关系。

在连续就诊的287例HF患者中,128例(45%)患者SIBO阳性。研究人员的结果显示,SIBO增加了射血分数降低的心衰患者再住院风险(P<0.001),以及射血分数正常的心衰患者心血管死亡风险(P=0.011)。SIBO是HF患者主要终点的独立危险因素(风险比[HR]为2.13;95%可信区间1.26-3.58;P=0.005)。此外,SIBO (CH4)对不良预后具有预测作用(HR为2.35;95%置信区间为1.38-4.02;P<0.001),而SIBO (H2)与患者结局之间的相关性无统计学意义。

由此可见,心力衰竭患者中SIBO的患病率很高,而且SIBO与患者不良预后独立相关。积极的SIBO治疗可以为心衰患者提供额外的益处。

原始出处:

Yu Song.et al.Association of Small Intestinal Bacterial Overgrowth With Heart Failure and Its Prediction for Short‐Term Outcomes.J AM HEART ASSOC.2021.https://www.ahajournals.org/doi/full/10.1161/JAHA.119.015292

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