Lankisch P G
Department of Internal Medicine, Municipal Hospital of Lüneberg, Federal Republic of Germany.
Int J Pancreatol. 1993 Aug;14(1):9-20. doi: 10.1007/BF02795225.
Direct pancreatic function tests, such as the secretin-pancreozymin test and the Lundh test, are--by direct measurement of the contents of duodenal secretion following exogenous (hormonal) or endogenous (test meal) stimulation--the best way to assess exocrine pancreatic function. However, these tests are time-consuming, invasive, and expensive, and therefore their use is limited to specialized centers only. Several studies have shown that indirect pancreatic function tests are a practicable alternative to direct pancreatic function tests for diagnosing exocrine pancreatic insufficiency. They allow staging of the disease and thereby facilitate comparison of different studies. They are also useful in some cases for determining whether pancreatic enzyme replacement therapy is necessary or not. In contrast to morphological procedures, they involve neither side effects, risks for the patient, nor complications for patients, investigators, and laboratory staff alike. The procedures being standardized, the test results depend to a lesser extent on the experience of the investigator, and more on the selection of and the instructions to the patient, and to some extent, on the severity of the exocrine pancreatic insufficiency. Like all pancreatic function tests, the indirect tests do not give a clue to etiology nor help investigators to differentiate between pancreatic insufficiency owing to chronic pancreatitis and that owing to pancreatic cancer. The role of pancreatic function tests in diagnosing early chronic pancreatitis in comparison to morphological examinations remains to be established.
直接胰腺功能测试，如促胰液素-胰酶泌素试验和伦德试验，通过在外源性（激素）或内源性（试验餐）刺激后直接测量十二指肠分泌物的成分，是评估胰腺外分泌功能的最佳方法。然而，这些测试耗时、具有侵入性且成本高昂，因此仅局限于专业中心使用。多项研究表明，间接胰腺功能测试是诊断胰腺外分泌功能不全时直接胰腺功能测试的一种可行替代方法。它们能够对疾病进行分期，从而便于不同研究之间的比较。在某些情况下，它们对于确定是否需要进行胰酶替代治疗也很有用。与形态学检查不同，它们既不会给患者带来副作用和风险，也不会给患者、研究人员和实验室工作人员带来并发症。由于这些检查程序已标准化，测试结果在较小程度上取决于研究人员的经验，而更多地取决于对患者的选择和指导，并且在一定程度上还取决于胰腺外分泌功能不全的严重程度。与所有胰腺功能测试一样，间接测试无法提示病因，也无助于研究人员区分慢性胰腺炎所致的胰腺功能不全和胰腺癌所致的胰腺功能不全。与形态学检查相比，胰腺功能测试在诊断早期慢性胰腺炎中的作用仍有待确定。
