Murphy M S, Eastham E J, Nelson R, Aynsley-Green A
Department of Child Health, University of Newcastle upon Tyne.
Arch Dis Child. 1990 Jun;65(6):574-8. doi: 10.1136/adc.65.6.574.
Techniques available for the study of lipase activity in the gut are unsatisfactory. Breath tests measuring labelled carbon dioxide (13CO2) may provide a useful means for this assessment. Six subjects with cystic fibrosis and pancreatic insufficiency and 10 controls received a test meal containing [13C] trioctanoin, and breath 13CO2 was measured using a dual inlet, dual detector isotope ratio mass spectrometer. Comparison of postprandial breath 13CO2 enrichment allowed complete separation between children with pancreatic insufficiency and controls. Administration of one capsule of pancreatic enzyme with the test meal resulted in an increase in 13CO2 production in all six patients, and four capsules produced a further increase in five of the six. Serial fat balance studies on four of the patients while receiving comparable doses of oral enzyme failed to demonstrate a progressive improvement in fat absorption. The [13C]trioctanoin breath test may prove a safe, non-invasive technique not only for the detection of pancreatic insufficiency, but also for the quantitative study of intraluminal lipolysis.
目前用于研究肠道脂肪酶活性的技术并不理想。测量标记二氧化碳（¹³CO₂）的呼气试验可能为这种评估提供一种有用的方法。六名患有囊性纤维化和胰腺功能不全的受试者以及十名对照者摄入了含有[¹³C]三辛酸甘油酯的试验餐，并使用双入口、双探测器同位素比率质谱仪测量呼出的¹³CO₂。餐后呼出的¹³CO₂富集量的比较能够将胰腺功能不全的儿童与对照者完全区分开来。在试验餐中服用一粒胰酶胶囊后，所有六名患者呼出的¹³CO₂量均增加，而六名患者中的五名在服用四粒胶囊后呼出的¹³CO₂量进一步增加。对其中四名患者在接受相当剂量口服酶时进行的系列脂肪平衡研究未能证明脂肪吸收有逐步改善。[¹³C]三辛酸甘油酯呼气试验可能不仅是一种安全、非侵入性的技术，可用于检测胰腺功能不全，还可用于腔内脂肪分解的定量研究。
