Henze E, Männer S, Clausen M, Malfertheiner P, Hellwig D, Ditschuneit H, Kornhuber H, Adam W E
Abteilungen Nuklearmedizin, Neurologie und Innere Medizin, Universität Ulm.
Klin Wochenschr. 1988 Apr 15;66(8):332-6. doi: 10.1007/BF01735789.
It was the purpose of this study to evaluate the diagnostic usefulness of an oral absorption test using nonlabeled Vit B12 suggested by a commercial distributor as an alternative for the more expensive Schilling test (ST). Plasma levels of Vit B12 were measured with a commercial kit before and 4 h after oral administration of 1 mg Vit B12 in 32 normals, in 16 patients with normal ST, and in 14 patients with abnormal ST for determination of sensitivity and specificity with the ST as golden standard. In normals, a mean of 767 +/- 404 pg/ml before and 1096 +/- 776 pg/ml after oral Vit B12 with a mean increase of 331 +/- 453 pg/ml was measured. Because of the obvious large variation, no meaningful range for normal absorption could be established. In the two patient subsets, there was no Gaussian distribution of the results, with a meridian of Vit B12 increase after absorption of 142 pg/ml, range 27-2668 pg/ml, in the group with normal ST and a meridian of 244 pg/ml ranging from 40 to 2453 pg/ml in the group with abnormal ST. Statistical nonparametric analysis did not reveal any difference between the two groups. Assuming a minimum required increase of 100 pg/ml, as suggested by the kit distributor, a sensitivity of only 27% and a specificity of 75% was obtained.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究旨在评估一种由商业经销商建议的口服未标记维生素B12吸收试验的诊断效用，以此作为更昂贵的希林试验（ST）的替代方法。在32名正常人、16名ST正常的患者以及14名ST异常的患者中，口服1毫克维生素B12前及4小时后，使用商业试剂盒测量血浆维生素B12水平，以ST作为金标准来确定敏感性和特异性。在正常人中，口服维生素B12前平均为767±404皮克/毫升，之后为1096±776皮克/毫升，平均增加331±453皮克/毫升。由于明显的巨大差异，无法确定正常吸收的有意义范围。在两个患者亚组中，结果不存在高斯分布，ST正常组吸收后维生素B12增加的中位数为142皮克/毫升，范围为27 - 2668皮克/毫升，ST异常组的中位数为244皮克/毫升，范围为40 - 2453皮克/毫升。统计非参数分析未显示两组之间有任何差异。按照试剂盒经销商建议的最低所需增加量100皮克/毫升计算，敏感性仅为27%，特异性为75%。（摘要截短于250字）
