Braden B, Picard H, Caspary W F, Posselt H G, Lembcke B
Medical Department II, University of Frankfurt/Main, Germany.
Z Gastroenterol. 1997 Feb;35(2):123-9.
13C-Hiolein is a randomly 13C-labeled mixture of long chain triglycerides synthesized by algae.
Because the 13C-Hiolein breath test is a suitable noninvasive tool to detect and monitor pancreatic steatorrhea, we used this new breath test for monitoring the effect of enzyme replacement therapy with an acid resistant enteric coated polydisperse pancreatin preparation (1.500 U/kg d) in children with cystic fibrosis.
Administration of 1.5 mg/kg 13-C-Hiolein together with a physiological mixed meal (1.5 g/kg rice cookies, containing 25% fat and 37% starch) resulted in significantly higher breath 13CO2/12CO2 ratios in controls than in cystic fibrosis children (maximal delta over baseline responses (DOBmax) 39.2 +/- 18.1% vs. 13.1 +/-13.9%; p < 0.001). With pancreatin, DOBmax in the cystic fibrosis patients responses returned completely to normal (39.2 +/- 29.2% DOBmax). A breath hydrogen increase indicating the malassimilation of starch was noticed in one patient with severe pancreatic insufficiency only.
In contrast to fecal fat analysis, the 13C-Hiolein breath test reflects postprandial fat assimilation immediately after a given, labeled meal. Monitoring the oxidative fate of physiological test meal with a stable isotope breath test, this study shows that fat assimilation in cystic fibrosis patients can be normalized with high dose pancreatin.
13C-海奥立因是一种由藻类合成的随机13C标记的长链甘油三酯混合物。
由于13C-海奥立因呼气试验是检测和监测胰腺脂肪泻的一种合适的非侵入性工具，我们使用这种新的呼气试验来监测一种耐酸肠溶包衣多分散胰酶制剂（1500 U/kg·d）对囊性纤维化儿童进行酶替代治疗的效果。
给予1.5 mg/kg的13C-海奥立因并同时摄入一顿生理混合餐（1.5 g/kg米饼，含25%脂肪和37%淀粉）后，对照组呼出气体中13CO2/12CO2的比值显著高于囊性纤维化儿童（相对于基线反应的最大差值（DOBmax）为39.2±18.1% vs. 13.1±13.9%；p<0.001）。使用胰酶后，囊性纤维化患者的DOBmax反应完全恢复正常（DOBmax为39.2±29.2%）。仅在一名严重胰腺功能不全的患者中观察到呼气氢增加，表明淀粉消化吸收不良。
与粪便脂肪分析不同，13C-海奥立因呼气试验可在摄入特定标记餐后立即反映餐后脂肪的吸收情况。通过稳定同位素呼气试验监测生理试验餐的氧化代谢情况，本研究表明高剂量胰酶可使囊性纤维化患者的脂肪吸收恢复正常。
