Farivar S, Fromm H, Schindler D, McJunkin B, Schmidt F W
Am J Clin Pathol. 1980 Jan;73(1):69-74. doi: 10.1093/ajcp/73.1.69.
The bile-acid breath test, fecal analysis of labeled bile acids, and Schilling test were used to study bile-acid and vitamin B12 metabolism in 31 patients with ileal Crohn's disease. Results of the bile-acid breath test were positive for 42% of the patients; Schilling test, 42%; fecal analysis of bile-acid labels, 19%. Combination of the tests increased the percentage of positive cases to 65. About 50% of the patients who had positive breath tests had evidence of normal bile-acid absorption, indicating increased bile-acid deconjugation by small-intestinal bacteria. The other 50% had evidence of various degrees of bile-acid malabsorption. Disease activity did not correlate with results of any test. Extent of ileal involvement correlated with results of the bile-acid tests, but not with those of the Schilling test. The study demonstrates that there is a wide spectrum of disturbances of bile-acid and vitamin B12 metabolism in ileitis, and that the tests should be useful in the diagnostic evaluation of patients with proven or questionable Crohn's disease who have diarrhea and malabsorptive abnormalities that could be related to disturbances of bile-acid and vitamin B12 metabolism.
采用胆汁酸呼气试验、标记胆汁酸粪便分析及希林试验，对31例回肠克罗恩病患者的胆汁酸和维生素B12代谢进行了研究。胆汁酸呼气试验结果显示，42%的患者呈阳性；希林试验为42%；胆汁酸标记物粪便分析为19%。联合检测使阳性病例百分比增至65%。约50%呼气试验呈阳性的患者有胆汁酸吸收正常的证据，表明小肠细菌使胆汁酸去结合作用增强。另外50%的患者有不同程度胆汁酸吸收不良的证据。疾病活动度与任何一项检测结果均无相关性。回肠受累程度与胆汁酸检测结果相关，但与希林试验结果无关。该研究表明，回肠炎患者存在广泛的胆汁酸和维生素B12代谢紊乱，这些检测对于已确诊或疑似克罗恩病且有腹泻和吸收不良异常（可能与胆汁酸和维生素B12代谢紊乱有关）的患者的诊断评估应是有用的。
