Steinberg W M, Salvato R F, Toskes P P
Gastroenterology. 1980 Apr;78(4):728-31.
The morphine-Prostigmin test has been used to diagnose disease of the sphincter of Oddi in patients with chronic abdominal pain. A twofold rise in amylase or lipase levels, reproduction of abdominal pain or both have been considered positive responses. A positive morphine-Prostigmin test has been used as a justification for a sphincteroplasty, a surgical procedure with significant morbidity. Little data are available on the response of control populations to morphine-Prostigmin, or the reproducibility of this test on different days. Ten healthy volunteers, 5 patients with symptoms of irritable bowel syndrome and 4 patients with chronic abdominal pain were given the morphine-Prostigmin test. Sixty percent of our healthy control subjects and patients with the irritable bowel syndrome had a marked elevation in amylase and lipase. Forty percent of those with the irritable bowel syndrome had reproduction of their typical abdominal pain after morphine-Prostigmin. Two of four patients with chronic abdominal pain had a different response to morphine-Prostigmin on second as compared to initial testing. We conclude that: (a) neither enzyme rise nor reproduction of abdominal pain produced by morphine-Prostigmin are specific for disease of the sphincter of Oddi, and (b) the morphine-Prostigmin test may give different results on different days in the same patient. Major clinical decisions should not be made on the basis of this test.
吗啡-新斯的明试验已被用于诊断慢性腹痛患者的Oddi括约肌疾病。淀粉酶或脂肪酶水平升高两倍、腹痛再现或两者兼有被视为阳性反应。阳性的吗啡-新斯的明试验一直被用作括约肌成形术（一种具有显著发病率的外科手术）的依据。关于对照人群对吗啡-新斯的明的反应，或该试验在不同日期的可重复性的数据很少。对10名健康志愿者、5名患有肠易激综合征症状的患者和4名慢性腹痛患者进行了吗啡-新斯的明试验。我们60%的健康对照受试者和肠易激综合征患者的淀粉酶和脂肪酶有显著升高。40%的肠易激综合征患者在接受吗啡-新斯的明治疗后出现了典型腹痛再现。4名慢性腹痛患者中有2名在第二次与初次测试时对吗啡-新斯的明的反应不同。我们得出结论：(a) 吗啡-新斯的明引起的酶升高和腹痛再现均非Oddi括约肌疾病所特有，(b) 吗啡-新斯的明试验在同一患者的不同日期可能会得出不同结果。不应基于该试验做出重大临床决策。
