外科理论与实践

外科理论与实践 ›› 2026, Vol. 31 ›› Issue (01): 64-69.doi: 10.16139/j.1007-9610.2026.01.11

• 论著 • 上一篇    下一篇

空腹呼气末H2S、NO、H2、CH4对大肠息肉临床诊断价值的研究

刘柠玮, 来爽, 关琳, 杨美琪, 李异玲()   

  1. 中国医科大学附属第一医院消化内科， 辽宁 沈阳 110001
  • 收稿日期:2025-07-09 出版日期:2026-02-25 发布日期:2026-04-21
  • 通讯作者: 李异玲，E-mail:lyl-72@163.com
  • 作者简介:作者贡献/Authors’ contributions

    刘柠玮负责研究设计、资料收集、整理数据和汇总、文献查阅、总结、撰写、翻译；来爽负责资料收集和撰写；关琳负责指导研究设计并修改文章；杨美琪负责资料收集和撰写；李异玲负责文章指导、研究设计、指导、审查、修订、修改文章。

Clinical diagnostic value of fasting end-expiratory H2S, NO, H2 and CH4 for colorectal polyps

LIU Ningwei, LAI Shuang, GUAN Lin, YANG Meiqi, LI Yiling()   

  1. Department of Gastroenterology, The first Affiliated Hospital of China Medical University, Liaoning Shenyang 110001, China
  • Received:2025-07-09 Online:2026-02-25 Published:2026-04-21

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摘要：

目的：评估空腹呼气末硫化氢（H2S）、一氧化氮（NO）、氢气（H2）、甲烷（CH4）对大肠息肉的诊断价值，探索性别、年龄等因素对以上标志物水平的影响。方法：纳入2024年1月至12月于中国医科大学附属第一医院245例结肠镜受试者，分为大肠息肉组（CP，n=117）与健康对照组（NC，n=128）。受试者于空腹状态下经呼气分析仪行呼气试验，检测H2S、NO、H2、CH4气体水平，分析组间差异，评估4种气体对大肠息肉的诊断效能，亚组分析影响因素结果。结果：分析受试者空腹呼气末H2S、NO、H2、CH4气体水平，发现CP组H2S显著高于NC组（107.50 ppb比9.00 ppb）（P<0.000 1），其余气体（NO、H2、CH4）两组间差异无统计学意义（P>0.05）；以肠镜加病理活检为标准，以H2S水平诊断CP的受试者工作特征曲线下面积（AUC）为0.966；男性及吸烟者H2S水平较高（P<0.01）。结论：空腹呼气末H2S作为一种新型大肠息肉非侵入性诊断标志物，诊断效能高，为大肠息肉的无创筛查提供了新策略。

关键词: 大肠息肉, 非侵入性诊断, 呼气生物标志物, 硫化氢, 结肠镜

Abstract:

Objective To evaluate the diagnostic value of fasting end-expiratory H2S, NO, H2, and CH4 for colorectal polyps, and to explore the impact of factors such as gender and age on these markers. Methods A total of 245 colonoscopy subjects from the First Affiliated Hospital of China Medical University from January 2024 to December 2024 were included, divided into colorectal polyp group (CP, n=117) and normal control group (NC, n=128). The subject underwent breath test, which used a breath analyzer in a fasting state to test the concentrations of H2S, NO, H2, and CH4.The differences between groups, as well as the results of subgroup analysis of influencing factors, were analyzed to evaluate the diagnostic efficacy of the four gases for colorectal polyps. Results Analyzing the concentrations of H2S, NO, H2, and CH4 gases at fasting end-expiratory of the subjects, it was found that the H2S level in the CP group was significantly higher than that in the NC group (107.50 ppb vs. 9.00 ppb) (P<0.000 1), while there were no differences of other gases (NO, H2, CH4) between the two groups (P>0.05); using colonoscopy and pathological examination as the standard, the AUC for diagnosing colorectal polyps with H2S concentration was 0.966; males and smokers had higher H2S concentration (P<0.01). End-expiratory H2S has high diagnostic efficacy as a novel non-invasive diagnostic marker for colorectal polyps, providing a new strategy for non-invasive screening of colorectal polyps. Conclusions Fasting end-expiratory H2S concentration is a novel non-invasive diagnostic marker for colorectal polyps, with high diagnostic efficacy, providing a new strategy for the non-invasive screening of colorectal polyps.

Key words: Colorectal polyp (CP), Non-invasive diagnosis, Expiratory biomarker, Hydrogen sulfide (H2S), Colonoscopy

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