中华皮肤科杂志 ›› 2024, Vol. 57 ›› Issue (2): 134-140.doi: 10.35541/cjd.20230503

• 论著 • 上一篇    下一篇

玫瑰痤疮患者小肠细菌过度生长情况调查及临床特征分析

马光荣1    谢红付1    刘家双2    周钟莲1    周淞麒1    黄莹雪1    李吉1   

  1. 1中南大学湘雅医院皮肤科  衰老生物学湖南省重点实验室  国家老年疾病临床医学研究中心（湘雅医院），长沙  410008；2中南大学湘雅医院消化科，长沙  410008
  • 收稿日期:2023-09-01 修回日期:2024-01-17 发布日期:2024-02-01
  • 通讯作者: 黄莹雪 E-mail:huangyingxue@csu.edu.cn

Small intestinal bacterial overgrowth in patients with rosacea: prevalence and clinical features

Ma Guangrong1, Xie Hongfu1, Liu Jiashuang2, Zhou Zhonglian1, Zou Songqi1, Huang Yingxue1, Li Ji1   

  1. 1Department of Dermatology, Hunan Key Laboratory of Aging Biology, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China; 2Department of Gastroenterology, Xiangya Hospital, Central South University, Changsha 410008, China
  • Received:2023-09-01 Revised:2024-01-17 Published:2024-02-01
  • Contact: Huang Yingxue E-mail:huangyingxue@csu.edu.cn

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摘要： 【摘要】 目的 调查玫瑰痤疮患者小肠细菌过度生长（SIBO）患病情况，分析不同呼气试验结果与玫瑰痤疮发病的关系。方法 纳入2022年3月至2023年6月于中南大学湘雅医院门诊就诊的玫瑰痤疮患者，采用甲烷氢呼气试验检测受试者肠道产甲烷及产氢情况，以评估SIBO患病情况。收集患者基本信息、临床症状及严重程度、生活质量评分、胃肠道症状及既往病史等资料。使用卡方检验、非参数检验及多因素logistic回归等进行数据统计分析，探讨SIBO与玫瑰痤疮发病的关系。结果 116例玫瑰痤疮患者完成了甲烷氢呼气试验，年龄18 ~ 56［25（22，33）］岁，男7例（6.0%），女109例（94.0%）；红斑型玫瑰痤疮43例（37.1%），丘疹脓疱型73例（62.9%）。其中，SIBO 94例（81.0%，95% CI：72.7% ~ 87.7%），氢气呼气试验阳性84例（72.4%，95% CI：63.3% ~ 80.3%），甲烷阳性47例（40.5%，95% CI：31.5% ~ 50%）。中重度红斑患者67例中，甲烷呼气试验阳性33例（49.3%），轻度者49例中甲烷阳性14例（28.6%），两组甲烷阳性率差20.7%（P = 0.025，95% CI：13.9% ~ 27.5%），SIBO及氢气阳性率在中重度红斑与轻度红斑组间差异无统计学意义（均P＞0.05）。年龄、性别、分型及丘疹脓疱、潮红、灼热的严重程度、玫瑰痤疮生活质量等在SIBO阳性与阴性组、氢气阳性与阴性组及甲烷阳性与阴性组间差异均无统计学意义（P＞0.05）。多因素logistic回归分析显示，甲烷阳性与玫瑰痤疮红斑严重程度相关（OR = 2.495，95% CI：1.102 ~ 5.649，P＜0.05）。结论 玫瑰痤疮患者中SIBO阳性率高，但仅甲烷阳性率与对照人群有差异，且甲烷阳性与玫瑰痤疮红斑严重程度增加存在一定相关性。

关键词: 红斑痤疮, 肠道微生态, 小肠细菌过度生长, 甲烷氢呼气试验

Abstract: 【Abstract】 Objective To investigate the prevalence of small intestinal bacterial overgrowth（SIBO） in patients with rosacea, and to analyze the relationship between breath test results and the occurrence of rosacea. Methods Patients with rosacea were enrolled from the outpatient department of Xiangya Hospital from March 2022 to June 2023. The methane-hydrogen breath test was used to detect intestinal levels of methane and hydrogen in all patients to investigate the prevalence of SIBO. The basic information, clinical symptoms and severity, quality of life scores, gastrointestinal symptoms, and past medical history of the patients were collected. Statistical analysis was carried out by using the chi-square test, nonparametric test and multivariate logistic regression models to investigate the relationship between SIBO and the occurrence of rosacea. Results A total of 116 patients with rosacea completed the methane-hydrogen breath test. They were aged 18 to 56 years （median ［Q1, Q3］: 25 ［22, 33］ years）, and included 7 males （6.0%） and 109 females （94.0%）; there were 43 cases （37.1%） of erythematotelangiectatic rosacea, and 73 （62.9%） of papulopustular rosacea. As the breath test showed, 94 patients were diagnosed with SIBO（81.0%, 95% CI: 72.7% - 87.7%）based on the breath tests, 84 showed positive hydrogen breath test results （72.4%, 95% CI: 63.3% - 80.3%）, and 47 had positive methane breath test results （40.5%, 95% CI: 31.5% - 50%）. Among the 67 patients with moderate to severe erythema, 33（49.3%） showed positive methane breath test results, and 14 of 49 （28.6%）patients with mild erythema showed positive methane breath test results, with a rate difference of 20.7% （P = 0.025, 95% CI: 13.9% - 27.5%）; there were no significant differences in the positive rates of SIBO and hydrogen breath test results between the patients with moderate to severe erythema and those with mild erythema （both P > 0.05）. No significant differences were observed in the age, gender, clinical subtypes, severity of papulopustules, flushing and burning sensation, or rosacea quality of life index scores between the SIBO-positive and -negative groups, between hydrogen-positive and -negative groups, and between methane-positive and -negative groups （all P > 0.05）. Multivariate logistic regression analysis showed that methane positivity on breath test was associated with the severity of erythema in rosacea （OR = 2.495, 95% CI: 1.102 - 5.649, P < 0.05）. Conclusions The prevalence of SIBO was relatively high in the patients with rosacea. However, only the positive rate of methane breath test differed between the rosacea patients and non-rosacea controls, and there was some correlation between methane positivity on breath test and increased severity of rosacea erythema.

Key words: Rosacea, Intestinal microecology, Small intestinal bacterial overgrowth, Methane-hydrogen breath tests

引用本文

马光荣 谢红付 刘家双 周钟莲 周淞麒 黄莹雪 李吉. 玫瑰痤疮患者小肠细菌过度生长情况调查及临床特征分析[J]. 中华皮肤科杂志, 2024,57(2):134-140. doi:10.35541/cjd.20230503

Ma Guangrong, Xie Hongfu, Liu Jiashuang, Zhou Zhonglian, Zou Songqi, Huang Yingxue, Li Ji. Small intestinal bacterial overgrowth in patients with rosacea: prevalence and clinical features[J]. Chinese Journal of Dermatology, 2024, 57(2): 134-140.doi:10.35541/cjd.20230503