Dastych Milan, Dastych Milan, Novotná Hana, Cíhalová J
Department of Clinical Biochemistry and Hematology, University Hospital Brno, Jihlavská 20, 62500, Brno, Czech Republic.
Dig Dis Sci. 2008 Oct;53(10):2789-92. doi: 10.1007/s10620-007-0184-8. Epub 2008 Mar 5.
The purpose of this study was to investigate and compare the specificity, sensitivity, and area under curve (AUC) of the lactulose/mannitol ratio, lactulose/creatinine ratio, and lactulose recovery and their diagnostic value for intestinal permeability assessment within the absorption lactulose/mannitol (L/M) test.
The value of the lactulose/mannitol ratio, lactulose/creatinine ratio, and the percentage of lactulose recovery in Crohn's disease (0.0763 +/- 0.0369; 99.62 +/- 67.87; 1.0478 +/- 0.6148) and in liver cirrhosis (0.0517 +/- 0.0365; 54.65 +/- 53.26; 0.838 +/- 0.929) were significantly different from the values measured in the control group (0.0123 +/- 0.0081; 10.95 +/- 7.07; 0.2438 +/- 0.1568), P < 0.0001-0.002). In Crohn's disease, specificity, sensitivity, and AUC were 100%, 89.5%, and 0.987, respectively, of the lactulose/mannitol ratio at a cut-off level of 0.022. In liver cirrhosis, the test characteristics were 88.5%, 84.2%, and 0.910 at a cut-off level of 0.018.
The lactulose/mannitol ratio was evaluated to have the highest diagnostic value to assess intestinal permeability.
本研究的目的是调查并比较乳果糖/甘露醇比值、乳果糖/肌酐比值、乳果糖回收率的特异性、敏感性和曲线下面积（AUC），以及它们在乳果糖/甘露醇（L/M）吸收试验中对肠道通透性评估的诊断价值。
克罗恩病患者的乳果糖/甘露醇比值、乳果糖/肌酐比值和乳果糖回收率（0.0763±0.0369；99.62±67.87；1.0478±0.6148）以及肝硬化患者的这些指标（0.0517±0.0365；54.65±53.26；0.838±0.929）与对照组（0.0123±0.0081；10.95±7.07；0.2438±0.1568）相比有显著差异，P<0.0001 - 0.002）。在克罗恩病中，当乳果糖/甘露醇比值的截断值为0.022时，其特异性、敏感性和AUC分别为100%、89.5%和0.987。在肝硬化中，当截断值为0.018时，检测特征分别为88.5%、84.2%和0.910。
评估得出乳果糖/甘露醇比值在评估肠道通透性方面具有最高的诊断价值。
