Levine J J, Seidman E, Walker W A
Am J Dis Child. 1987 Apr;141(4):435-8. doi: 10.1001/archpedi.1987.04460040093024.
Three widely used screening tests for enteropathy in childhood are the lactose breath hydrogen test, the one-hour serum D-xylose absorption test, and the 72-hour fecal fat determination. To our knowledge, no study has compared these three tests and jejunal biopsy results. A retrospective survey of all jejunal biopsy results at Children's Hospital, Boston, from July 1983 to July 1984 was undertaken to evaluate which test best predicted a normal biopsy result. None of the screening tests was ideal. The lactose breath test had low sensitivity and specificity and did not correlate significantly with biopsy results. The D-xylose and fecal fat tests were each significantly correlated with biopsy results; a normal result of either test was highly predictive of a normal biopsy result. Combining the results of two or more screening tests did not improve predictive value. The xylose test is preferable on the basis of greater sensitivity and ease of patient compliance.
三种广泛用于儿童肠病筛查的测试分别是乳糖呼气氢测试、一小时血清D-木糖吸收测试和72小时粪便脂肪测定。据我们所知，尚无研究对这三种测试与空肠活检结果进行比较。我们对1983年7月至1984年7月期间波士顿儿童医院所有空肠活检结果进行了回顾性调查，以评估哪种测试能最好地预测正常活检结果。没有一种筛查测试是理想的。乳糖呼气测试的敏感性和特异性较低，与活检结果无显著相关性。D-木糖测试和粪便脂肪测试均与活检结果显著相关；任一测试的正常结果都高度预示着活检结果正常。结合两种或更多筛查测试的结果并不能提高预测价值。基于更高的敏感性和患者更好的依从性，木糖测试更可取。
