Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, Shandong, China.
Pancreas. 2011 Apr;40(3):422-5. doi: 10.1097/MPA.0b013e318204e89a.
Secretin pancreatic function tests play an important role in the diagnosis of chronic pancreatitis. Back titration is the standard method for measurement of bicarbonate in pancreatic juice but is time consuming and manually performed. Use of an autoanalyzer for this purpose is not validated.
Bicarbonate concentrations in secretin-stimulated pancreatic juice specimens were quantitated by manual back titration, a clinical chemistry autoanalyzer (automated bicarbonate, Roche Cobas c501, Roche Diagnostics, Indianapolis, Ind), and a blood gas analyzer (calculated bicarbonate, GEM 3000, Instrumentation Laboratories, Bedford, Mass). Kappa statistic analysis, Bland-Altman analysis, and Lin concordance correlation coefficients were calculated.
Ninety specimens from 31 subjects were included. Using a bicarbonate concentration of 80 mEq/L as a cutoff value, there was poor agreement between back titration and calculated bicarbonate (κ = 0.188); however, only 1 specimen showed discrepancy between back titration and automated bicarbonate (κ = 0.977). The limit of agreement between the back titration and automated bicarbonate was -9.0 to + 8.3 mEq/L. The Lin concordance correlation coefficient between the 2 methods was 0.931 (P < 0.001).
There is strong concordance between manual back titration and chemistry autoanalyzer methods for measurement of bicarbonate concentrations in pancreatic juice. Autoanalyzers may replace back titration for this purpose. Blood gas analyzers are unsuitable.
缩胆囊素胰腺功能试验在慢性胰腺炎的诊断中起着重要作用。回滴滴定法是测量胰液中碳酸氢盐的标准方法，但耗时且手动进行。为此目的使用自动分析仪尚未得到验证。
通过手动回滴滴定、临床化学自动分析仪（罗氏 Cobas c501，罗氏诊断公司，印第安纳波利斯，印第安纳州）和血气分析仪（计算的碳酸氢盐，Instrumentation Laboratories，贝德福德，马萨诸塞州）定量测定缩胆囊素刺激的胰液标本中的碳酸氢盐浓度。计算了 Kappa 统计分析、Bland-Altman 分析和 Lin 一致性相关系数。
共纳入 31 例受试者的 90 份标本。使用碳酸氢盐浓度 80 mEq/L 作为截断值，回滴滴定和计算的碳酸氢盐之间的一致性较差（κ=0.188）；然而，只有 1 份标本的回滴滴定和自动碳酸氢盐之间存在差异（κ=0.977）。回滴滴定和自动碳酸氢盐之间的界限差异为-9.0 至+8.3 mEq/L。两种方法之间的 Lin 一致性相关系数为 0.931（P<0.001）。
手动回滴滴定和化学自动分析仪方法在测量胰液中碳酸氢盐浓度方面具有很强的一致性。自动分析仪可以替代回滴滴定用于此目的。血气分析仪不适合。
