Suppr超能文献

[血浆氨基酸水平——以α-氨基氮表示——对外分泌胰腺刺激的反应:一种新的胰腺功能测试方法]

[Amino acid level in plasma--expressed as alpha-amino-nitrogen--reaction to stimulation of the exocrine pancreas: approaches to a new pancreatic function test].

作者信息

Heptner G, Domschke S, Schneider M U, Kolb S, Domschke W

机构信息

Medizinische Klinik mit Poliklinik, Universität Erlangen-Nürnberg.

出版信息

Klin Wochenschr. 1987 Nov 2;65(21):1054-61. doi: 10.1007/BF01726325.

Abstract

We determined by the ninhydrin method the plasma amino acid (AA) levels prior to, during and following, a 1-hour i.v. infusion of 1 U/kg body weight each of secretin and pancreozymin in patients with normal (n = 74) or reduced (n = 39) exocrine pancreatic function, as assessed by the duodenal aspiration test. The results of the two tests correlated significantly with each other (p less than 0.001). A maximum AA decrease of greater than or equal to 12% was observed in all patients with a normally functioning pancreas (specificity 100%), and of less than 12% in all patients with medium to high-grade impairment of pancreatic function (sensitivity 100%). Since, however, low-grade pancreas insufficiency (20-40% of the mean normal enzyme output) is recognized in fewer than one-half of the cases, the overall sensitivity of the AA-consumption test decreases to 69%. The results can, however, be improved by: 1) Calculating the mean percentage AA decrease with a limit value of 5% (sensitivity 90%); 2) determining individual AA with pancreas-specific absorption, such as serine (sensitivity 92%); 3) dropping the lower normal value of exocrine pancreatic function to 25% of the normal mean enzyme output (sensitivity 96%). Diseases that may be associated with the most common condition that causes pancreatic insufficiency--chronic pancreatitis--and which have an influence on AA metabolism, such as cirrhosis of the liver and diabetes mellitus, have no influence on the accuracy of the AA consumption test, which, considered overall, represents a competitive alternative to other tubeless tests of pancreatic function.

摘要

我们采用茚三酮法测定了正常(n = 74)或外分泌胰腺功能降低(n = 39)患者在静脉输注每千克体重1单位促胰液素和胰酶泌素1小时之前、期间及之后的血浆氨基酸(AA)水平,外分泌胰腺功能通过十二指肠抽吸试验评估。两项试验结果显著相关(p < 0.001)。在所有胰腺功能正常的患者中均观察到AA最大降幅大于或等于12%(特异性100%),而在所有胰腺功能中至重度受损的患者中AA降幅均小于12%(敏感性100%)。然而,由于轻度胰腺功能不全(平均正常酶输出量的20 - 40%)在不到一半的病例中被识别出来,AA消耗试验的总体敏感性降至69%。不过,结果可通过以下方式得到改善:1)计算AA平均降幅百分比,限值为5%(敏感性90%);2)测定具有胰腺特异性吸收的单个AA,如丝氨酸(敏感性92%);3)将外分泌胰腺功能的正常下限值降至正常平均酶输出量的25%(敏感性96%)。可能与导致胰腺功能不全的最常见病症——慢性胰腺炎相关且对AA代谢有影响的疾病,如肝硬化和糖尿病,对AA消耗试验的准确性没有影响,总体而言,该试验是胰腺功能其他无管试验的一种有竞争力的替代方法。

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验