Malfertheiner P, Büchler M, Müller A, Ditschuneit H
Pancreas. 1987;2(1):53-60. doi: 10.1097/00006676-198701000-00009.
The value of a modified fluorescein dilaurate (FDL) serum test for the detection of pancreatic exocrine insufficiency was investigated in 89 patients with and without pancreatic disease. This test modification with fluorescein serum determination following metoclopramide (10 mg) and secretin (1 U/kg) i.v. injection appeared efficacious in a pilot study in six healthy volunteers. Individual peak fluorescein serum concentration was achieved within 180 min after the test meal in 96% of all subjects studied. Peak fluorescein serum concentration within this time period allowed the best discrimination between normal and abnormal pancreatic function. Sensitivity in detection of chronic pancreatitis was 86% (38 of 44 patients) when the lower normal fluorescein serum concentration was considered 4.5 micrograms/ml (this value corresponds to mean - 2 SD). The specificity of this test in detecting chronic pancreatitis was 100% when healthy controls were considered, but fell to 78% when patients with different gastrointestinal disorders, including those with secondary pancreatic insufficiency, were included. The correlation between serum and urinary fluorescein determination was significant (r = 0.61; p less than 0.01). Duodenal bicarbonate output/h after secretin also showed a significant correlation with peak fluorescein serum concentration (r = 0.79; p less than 0.001).
在89例有或无胰腺疾病的患者中，研究了改良荧光素二月桂酸酯（FDL）血清试验对检测胰腺外分泌功能不全的价值。在一项针对6名健康志愿者的初步研究中，静脉注射甲氧氯普胺（10毫克）和促胰液素（1单位/千克）后进行荧光素血清测定的这种试验改良似乎是有效的。在所有研究对象中，96%的人在试餐后180分钟内达到了个体荧光素血清浓度峰值。在此时间段内的荧光素血清浓度峰值能最好地区分正常和异常的胰腺功能。当将正常荧光素血清浓度下限设定为4.5微克/毫升（该值对应于均值 - 2倍标准差）时，检测慢性胰腺炎的敏感性为86%（44例患者中的38例）。当考虑健康对照时，该试验检测慢性胰腺炎的特异性为100%，但当纳入包括继发性胰腺功能不全患者在内的不同胃肠道疾病患者时，特异性降至78%。血清荧光素测定与尿荧光素测定之间的相关性显著（r = 0.61；p < 0.01）。促胰液素刺激后十二指肠碳酸氢盐输出量/小时也与荧光素血清浓度峰值显著相关（r = 0.79；p < 0.001）。
