^(13)C-Hiolein呼气试验对胰腺外分泌功能检测的临床应用

^(13) C labelled Hiolein breath test for assessing pancreatic exocrine insufficiency

目的 测定慢性胰腺炎 (CP) 13 C Hiolein脂肪酸呼气试验 ,了解对胰腺功能检测的临床意义。方法 A组 8例正常志愿者为对照 ,8例无脂肪泻CP为B组 ,8例有脂肪泻CP为C组 ,进食13 C Hiolein后 ,检测呼气中13 CO2 ,评估胰腺的外分泌功能。C组患者补充胰酶后再行13 C Hiolein试验。结果 C组13 C Hiolein呼气试验显示 ,13 C峰值 (PDRpeak)和 6h呼出13 C累积丰度 (cPDR)较A组明显降低[(1.5 3± 0 .36 ) %比 (2 .87± 0 .73) % ;(6 .11± 0 .5 9) %比 (11.2 2± 1.2 2 ) % ;P <0 .0 1],补充胰酶后PDRpeak和cPDR/6h较治疗前明显升高 [(2 .33± 0 .47) % ,(9.0 3± 0 .84) % ;P <0 .0 1],但cPDR/6h低于正常对照组 (P <0 .0 5 ) ;B组PDRpeak和cPDR/6h与对照组无明显差异。13 C通常在 (5 .90± 1.17)h达到PDRpeak峰值。结论 13 C

Objective To assess the exocrine pancreatic function by the 13 C Hiolein breath test. Methods Group A consisted of 8 volunteers without pancreatic diseases served as controls. Sixteen patients were chronic pancreatitis(CP). Group B consisted of 8 chronic pancreatitis patients without steatorrhea, and group C consisted of 8 chronic pancreatitis patients with steatorrhea. The 13 C Hiolein breath test and faecal fat to monitor exocrine pancreatic function were performed. After having been treated with enzyme replacement, patients in group C were performed the breath test again. Results After administered 13 C Hiolein together with a fixed pudding, the dosage of 13 C/h maximal PDR (PDRpeak) and cumulative percent dosage of 13 C recovery per 6 h(cPDR/6 h) in group A were significantly higher than that in group C [(2.87±0.73)% vs. (1.53±0.36)%; (11.22±1.22)% vs. (6.11±0.59)%; P <0.01] respectively. Group C patients were given repeated tests after pancreatic enzyme supplementation and showed significantly rise of PDRpeak and cPDR/6 h [(2.33±0.47)%, (9.03±0.84)%; P <0.01], but cPDR/6 h was lower than that of controls ( P < 0.05). The PDRpeak and cPDR in group B patients had no difference from group A. The time of PDRpeak was (5.90±1.17) h in group B. Conclusions In patients with chronic pancreatitis, the 13 C Hiolein breath test reflects the fat metabolism and monitors the therapentic efficacy of pancreatic enzymes.