时间: 2022年05月15日 09:30 | 作者：朗依制药 | 来源: 医药资讯| 阅读: 169次
指南共识 | 胃肠道疾病氢呼气试验的方法和适应症
2022-05-05 13:03 来源: 乐雅生物
原标题：指南共识 | 胃肠道疾病氢呼气试验的方法和适应症
内容来源：消化界&乐雅生物
前言：
“甲烷和氢呼气试验”是基于菌群代谢组学的气体分析，测量呼出气体中氢气和甲烷的浓度，诊断小肠细菌过度生长、乳糖不耐受、口盲传输时间、胰腺外分泌功能等疾病。该试验广泛应用于功能性胃肠病和胃肠外疾病的病因诊断，并指导治疗，同时用于疗效评估和预后监测。
随着医疗的规范化和决策的科学化，共识指南在医学实践中的作用和意义越来越重要。近年来，“甲烷和氢呼气试验”相关的学术研究及论述热度也在逐年攀升。国外已有明确的共识指南，而国内目前部分医务人员对“甲烷和氢呼气试验”共识指南的认识和理解仍有不足。鉴于此，乐雅生物特联合消化界重磅推出“甲烷和氢呼气学院”共识指南专辑。
专辑将对近15年来的技术发展做深度汇总解读，旨在提高医务人员对“甲烷和氢呼气试验”的理解和认识，为临床诊断和治疗决策提供有价值的临床信息。同时，乐雅生物正协同临床专家共同进行相关的学术研究，助推我国“甲烷和氢呼气试验”的共识指南落地并切实指导临床、规范诊疗路径。
Methodology and indications of H2-breath
testing in gastrointestinal diseases:
the Rome Consensus Conference
胃肠道疾病氢呼气试验的方法和适应症：
罗马共识会议
1.Background 背景
Breath tests represent a valid and non-invasive diagnostic tool in many gastroenterological conditions. The rationale of hydrogen-breath tests is based on the concept that part of the gas produced by colonic bacterial fermentation diffuses into the blood and is excreted by breath, where it can be quantified easily. There are many differences in the methodology, and the tests are increasingly popular.
呼气试验，在许多胃肠病的应用中，是一种有效的、无创的诊断工具。氢呼气试验的基本原理是基于结肠细菌发酵产生的部分气体扩散到血液中，并通过呼吸排出，这个时候很容易被量化。呼气氢检测方法多样化，测试也越来越流行。
2.Aim 目的
The Rome Consensus Conference was convened to offer recommendations for clinical practice about the indications and methods of H2-breath testing in gastrointestinal diseases.
召开罗马共识会议，是为了就胃肠道疾病中氢呼气试验的适应症和指标的临床实践提供建议。
3.Methods 方法
Experts were selected on the basis of a proven knowledge/expertise in H2-breath testing and divided into Working Groups (methodology; sugar malabsorption; small intestine bacterial overgrowth; oro-coecal transit time and other gas-related syndromes). They performed a systematic review of the literature, and then formulated statements on the basis of the scientific evidence, which were debated and voted by a multidisciplinary Jury. Recommendations were then modified on the basis of the decisions of the Jury by the members of the Expert Group.
专家的选择是基于呼气试验方面的专业知识，并分为肠道气体代谢导论、成人和儿童的检测方法、碳水化合物吸收不良、小肠细菌过度生长、口盲传输时间、其他气体相关综合征、应用方法和适应症等工作组。他们对文献进行了系统的回顾，根据科学证据制定了陈述，并由多学科陪审团进行辩论和表决，最终专家组成员根据陪审团的决定修改建议。
4.Results and conclusions 结果与讨论
The final statements, graded according to the level of evidence and strength of recommendation, are presented in this document; they identify the indications for the use of H2-breath testing in the clinical practice and methods to be used for performing the tests.
根据质证水平和专家推荐强度，对最终共识声明进行分级，共识确定了在临床实践中使用氢呼气试验的适应症和进行试验的方法。
4.1
Stationary dedicated gaschromatographs represent the gold standard for hydrogen determinations in breath, as they were previously validated in comparison with nondedicated instruments, and tested in terms of linearity and reproducibility of results.2–4
与非专用仪器进行了验证，并在结果的线性和重复性方面进行了测试，固定专用气相色谱仪代表了氢呼气测定的金标准。2–4
4.2
Standard gaschromatographs represent instruments not dedicated to the measurement of specific gases and use columns that can dose trace molecules, for example, for toxicology purposes.
气相色谱，通过色谱柱实现ppm（10-6）痕量级别的分子分析。
4.3
No data are available on reproducibility or long-term stability of the electrochemical cell, which is characterized by a relatively short life.
没有关于电化学法重复性、长期稳定性的数据，且寿命相对较短。
4.4