Lucas M H, Elgazzar A H
Department of Radiology, E.L. Saenger Radioisotope Laboratory, University of Cincinnati Medical Center, OH 45267-0577.
Clin Nucl Med. 1994 Nov;19(11):1001-3. doi: 10.1097/00003072-199411000-00015.
The Schilling test is used to identify the cause of vitamin B12 malabsorption in patients with low serum vitamin B12 levels. The initial step required for vitamin B12 absorption is a process of separation from the protein complexes of food. The crystalline Co-57 vitamin B12 used in the Schilling test does not reproduce this physiologic process. Thus, a crystalline stage I Schilling test may be normal even in the face of cobalamin malabsorption. An adjunctive stage I Schilling test using Co-57 vitamin B12 bound to protein has been developed. The authors describe a patient with protein-bound vitamin B12 malabsorption whose crystalline Co-57 vitamin B12 stage I Schilling test was normal. A subsequent stage I Schilling test using Co-57 vitamin B12 bound to chicken serum revealed significant cobalamin malabsorption. A review of the history and literature of this diagnostic test using protein bound vitamin B12 is also presented.
希林试验用于确定血清维生素B12水平低的患者维生素B12吸收不良的原因。维生素B12吸收所需的初始步骤是与食物中的蛋白质复合物分离的过程。希林试验中使用的结晶型钴-57维生素B12并不能重现这一生理过程。因此，即使存在钴胺素吸收不良，结晶型I期希林试验也可能正常。已开发出一种使用与蛋白质结合的钴-57维生素B12的辅助性I期希林试验。作者描述了一名患有蛋白质结合型维生素B12吸收不良的患者，其结晶型钴-57维生素B12 I期希林试验结果正常。随后使用与鸡血清结合的钴-57维生素B12进行的I期希林试验显示出明显的钴胺素吸收不良。本文还对使用蛋白质结合型维生素B12的这项诊断试验的历史和文献进行了综述。
