Gowen G F
Department of Surgery, Pennsylvania Hospital, Philadelphia.
Am Surg. 1989 Oct;55(10):640-4.
In a prospective five-year study of 65 consecutive patients with upper abdominal pain the Neostigmine Morphine Test (NMT) was applied as a screen for biliary, ampullary, and pancreatic disease. Three facts emerged from this study: 1) the amylase and lipase were overly sensitive, but not specific and had only a 10 per cent predictive value for ampullary obstruction; 2) the bilirubin, alkaline phosphatase, and serum glutamic oxaloacetic transaminase (SGOT) were positive in patients with ampullary obstruction if they were postcholecystectomy but not so in patients with an intact gallbladder, which may be explained by the third observation; 3) the gallbladder can compensate for partial ampullary obstruction by dilatation five to ten times and by its ability to absorb 90 per cent of the water content of the bile. The Neostigmine Morphine Test is not a reliable screen for ampullary obstruction and positive findings must be confirmed by other studies.
在一项针对65例连续的上腹部疼痛患者进行的为期五年的前瞻性研究中，新斯的明吗啡试验（NMT）被用作筛查胆道、壶腹和胰腺疾病的方法。该研究得出了三个结论：1）淀粉酶和脂肪酶过于敏感，但不具有特异性，对壶腹梗阻的预测价值仅为10%；2）胆红素、碱性磷酸酶和血清谷草转氨酶（SGOT）在胆囊切除术后的壶腹梗阻患者中呈阳性，但在胆囊完整的患者中并非如此，这可能由第三个观察结果解释；3）胆囊可通过扩张五到十倍以及吸收90%胆汁水分的能力来代偿部分壶腹梗阻。新斯的明吗啡试验并非壶腹梗阻的可靠筛查方法，阳性结果必须通过其他研究加以证实。
