Thoeni R F, Vandeman F, Wall S D
AJR Am J Roentgenol. 1984 Jan;142(1):111-4. doi: 10.2214/ajr.142.1.111.
The effect of glucagon-induced hypotonicity on the diagnostic accuracy of double-contrast barium enema examinations was determined in 133 consecutive patients in a double-blind crossover study. All patients underwent colonoscopy and served as their own controls by undergoing a double-contrast study after intravenous injection of 1 mg of glucagon and another after intravenous injection of 1 ml of saline placebo, in randomized order. The frequencies of good/excellent hypotonicity and quality of examinations after first doses of glucagon (55.3% and 80.8%) were not significantly different from the frequencies of good/excellent results after first doses of saline (51.3% and 86.5%). The sensitivity was 72.6% after glucagon and 64.5% after placebo; the specificity was 88.7% after glucagon and 77.9% after placebo; and the respective accuracies were 81.2% and 71.9%. These percentages should be used only to compare results with and without glucagon and, by study design, do not represent results of a complete double-contrast study. The variation among these percentages was not statistically significant, but diverticulitis was more accurately diagnosed after glucagon. It was concluded that glucagon does not significantly improve the sensitivity and specificity of the double-contrast barium enema examination and should be used only in selected instances.
在一项双盲交叉研究中，对133例连续患者进行了研究，以确定胰高血糖素诱导的低张性对双重对比钡剂灌肠检查诊断准确性的影响。所有患者均接受结肠镜检查，并通过随机顺序在静脉注射1mg胰高血糖素后进行双重对比研究，以及在静脉注射1ml生理盐水安慰剂后进行另一项双重对比研究，以自身作为对照。首次注射胰高血糖素后良好/极佳低张性的频率和检查质量（分别为55.3%和80.8%）与首次注射生理盐水后良好/极佳结果的频率（分别为51.3%和86.5%）无显著差异。使用胰高血糖素后的敏感性为72.6%，使用安慰剂后的敏感性为64.5%；使用胰高血糖素后的特异性为88.7%，使用安慰剂后的特异性为77.9%；各自的准确性分别为81.2%和71.9%。这些百分比仅应用于比较使用和未使用胰高血糖素的结果，根据研究设计，并不代表完整双重对比研究的结果。这些百分比之间的差异无统计学意义，但使用胰高血糖素后对憩室炎的诊断更准确。研究得出结论，胰高血糖素不会显著提高双重对比钡剂灌肠检查的敏感性和特异性，仅应在特定情况下使用。
