Department of Internal Medicine, Israelitic Hospital in Hamburg, Academic Hospital of the University of Hamburg, Hamburg, Germany.
Pancreas. 2011 Nov;40(8):1201-5. doi: 10.1097/MPA.0b013e318220ad98.
The noninvasive ¹³C-mixed triglyceride breath test (¹³C-MTG-T) has been shown to diagnose severe pancreatic exocrine insufficiency reliably. We hypothesized that sensitivity of the test could be increased by strict limitation of physical activity, correction for gastric emptying velocity, and/or increased lipid dose.
In 10 healthy volunteers and 9 patients with suspected pancreatic disease, a secretin test, a modified ¹³C-MTG-T (250 mg ¹³C-MTG, 26 g fat, breath samples over 8 hours), and a ¹³C-octanoic acid gastric emptying test were performed. Subjects remained strictly seated during breath testing.
Intravenously administered secretin 1 U/kg·h stimulated outputs of all enzymes significantly. Mean basal and stimulated enzyme outputs were similar in patients and healthy controls; however, compared with normal values, 5 patients and 1 control had moderately decreased lipase output. Cumulative 4-, 6-, and 8-hour ¹³C exhalation was significantly lower in patients than in controls. Sensitivity of ¹³C-MTG-T (6-h cumulative ¹³C exhalation <27% of dose) for detection of decreased lipase output was 100%; specificity was 92%. Gastric emptying parameters were similar in patients and controls, and correction for these did not improve accuracy of ¹³C-MTG-T.
The modified ¹³C-MTG-T detects moderate pancreatic exocrine insufficiency.
¹³C-混合甘油三酯呼吸试验（¹³C-MTG-T）已被证明可可靠地诊断严重的胰腺外分泌功能不全。我们假设通过严格限制体力活动、校正胃排空速度和/或增加脂质剂量，可以提高该试验的敏感性。
在 10 名健康志愿者和 9 名疑似胰腺疾病患者中，进行了促胰液素试验、改良的¹³C-MTG-T（250mg¹³C-MTG，26g 脂肪，呼吸样本采集 8 小时）和¹³C-辛酸胃排空试验。在呼吸测试期间，受试者严格保持坐姿。
静脉内给予 1U/kg·h 的促胰液素显著刺激所有酶的分泌。患者和健康对照组的基础和刺激后酶分泌均值相似；然而，与正常值相比，5 名患者和 1 名对照者的脂肪酶分泌量中度降低。与对照组相比，患者的 4 小时、6 小时和 8 小时¹³C 呼气累积量显著降低。¹³C-MTG-T（6 小时累积¹³C 呼气量<剂量的 27%）检测到的脂肪酶分泌减少的敏感性为 100%；特异性为 92%。患者和对照组的胃排空参数相似，校正这些参数并不能提高¹³C-MTG-T 的准确性。
改良的¹³C-MTG-T 可检测到中度的胰腺外分泌功能不全。
