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胰腺外分泌功能检测方法的临床应用

左林 杨都江 陆慧敏

引用本文:
Citation:

胰腺外分泌功能检测方法的临床应用

DOI: 10.3969/j.issn.1001-5256.2022.04.044
基金项目: 

四川省科技厅项目 (2018SZ0381);

四川大学华西医院学科卓越发展1.3.5工程项目 (ZYJC18027)

利益冲突声明:所有作者均声明不存在利益冲突。
作者贡献声明:陆慧敏负责文章设计,修改论文;左林、杨都江负责文献检索和分析,撰写文章。
详细信息
    通信作者:

    陆慧敏,hm.lu@scu.edu.cn

Clinical application of pancreatic exocrine function tests

Research funding: 

The Sichuan Provincial Department of Science and Technology Supporting Project (2018SZ0381);

1.3.5 Project for Disciplines of Excellence, West China Hospital, Sichuan University (ZYJC18027)

More Information
  • 摘要: 胰腺外分泌功能的检测方法较多,且各种方法的检测指标不同,尚无统一标准。本文总结了临床上应用较广泛或具有良好应用前景的胰腺外分泌功能检测方法,简述了各种方法的操作过程并评述了其临床实用性和进展,为胰腺外分泌功能检测方法的临床应用与研究思路提供一定的参考。

     

  • [1] HUANG ZX, WANG CW, LIU L, et al. Magnetic resonance imaging in assessment of pancreatic exocrine function: current status[J]. Chin J Bases Clin Gen Surg, 2019, 26(12): 1476-1479. DOI: 10.7507/1007-9424.201910090.

    黄子星, 王成伟, 刘苓, 等. 胰腺外分泌功能的磁共振成像研究进展[J]. 中国普外基础与临床杂志, 2019, 26(12): 1476-1479. DOI: 10.7507/1007-9424.201910090.
    [2] TAN Y, HAN LQ, YANG Q, et al. Impairment of endocrine function in acute pancreatitis[J/CD]. Chin J Clinicians(Electronic Edition), 2018, 12(9): 535-538. DOI: 10.3877/cma.j.issn.1674-0785.2018.09.011.

    谭杨, 韩连强, 杨奇, 等. 急性胰腺炎时胰腺内分泌功能损伤的研究进展[J/CD]. 中华临床医师杂志(电子版), 2018, 12(9): 535-538. DOI: 10.3877/cma.j.issn.1674-0785.2018.09.011.
    [3] CARNIE LE, LAMARCA A, MCNAMARA MG, et al. The assessment of pancreatic exocrine function in patients with inoperable pancreatic cancer: In need of a new gold-standard[J]. Pancreatology, 2020, 20(4): 668-675. DOI: 10.1016/j.pan.2020.03.020.
    [4] CAI ZH, LI G, BAO SH, et al. Analysis of influencing factors for pancreatic endocrine and exocrine insufficiency after pancreaticoduodenectomy[J]. Chin J Dig Surg, 2020, 19(4): 414-420. DOI: 10.3760/cma.j.cn115610-20200409-00243.

    蔡正华, 李刚, 包善华, 等. 胰十二指肠切除术后发生胰腺内外分泌功能不全的影响因素分析[J]. 中华消化外科杂志, 2020, 19(4): 414-420. DOI: 10.3760/cma.j.cn115610-20200409-00243.
    [5] CHAUDHARY A, DOMÍNGUEZ-MUÑOZ JE, LAYER P, et al. Pancreatic exocrine insufficiency as a complication of gastrointestinal surgery and the impact of pancreatic enzyme replacement therapy[J]. Dig Dis, 2020, 38(1): 53-68. DOI: 10.1159/000501675.
    [6] ALTAY M. Which factors determine exocrine pancreatic dysfunction in diabetes mellitus?[J]. World J Gastroenterol, 2019, 25(22): 2699-2705. DOI: 10.3748/wjg.v25.i22.2699.
    [7] PERBTANI Y, FORSMARK CE. Update on the diagnosis and management of exocrine pancreatic insufficiency[J]. F1000Res, 2019, 8: F1000 Faculty Rev-1991. DOI: 10.12688/f1000research.20779.1.
    [8] ANAIZI A, HART PA, CONWELL DL. Diagnosing chronic pancreatitis[J]. Dig Dis Sci, 2017, 62(7): 1713-1720. DOI: 10.1007/s10620-017-4493-2.
    [9] GHEORGHE C, SEICEAN A, SAFTOIU A, et al. Romanian guidelines on the diagnosis and treatment of exocrine pancreatic insufficiency[J]. J Gastrointestin Liver Dis, 2015, 24(1): 117-123. DOI: 10.15403/jgld.2014.1121.app.
    [10] DOMÍNGUEZ MUÑOZ JE. Diagnosis of chronic pancreatitis: Functional testing[J]. Best Pract Res Clin Gastroenterol, 2010, 24(3): 233-241. DOI: 10.1016/j.bpg.2010.03.008.
    [11] JENSEN NM, LARSEN S. A rapid, endoscopic exocrine pancreatic function test and the Lundh test: A comparative study[J]. Pancreatology, 2008, 8(6): 617-624. DOI: 10.1159/000161013.
    [12] LIN J, HU L, LIAO Z. Clinical application of pancreatic exocrine function examination[J]. Acad J Second Military Med Univ, 2017, 38(10): 1298-1303. DOI: 10.16781/j.0258-879x.2017.10.1298.

    林金, 胡良, 廖专, 等. 胰腺外分泌功能检测方法应用现状[J]. 第二军医大学学报, 2017, 38(10): 1298-1303. DOI: 10.16781/j.0258-879x.2017.10.1298.
    [13] DREILING DA, HOLLANDER F. Studies in pancreatic function; preliminary series of clinical studies with the secretin test[J]. Gastroenterology, 1948, 11(5): 714-729.
    [14] HORVATH K, MEHTA DI, HILL ID. Assessment of exocrine pancreatic function during endoscopy in children[J]. J Pediatr Gastroenterol Nutr, 2019, 68(6): 768-776. DOI: 10.1097/MPG.0000000000002230.
    [15] MEHTA DI, HE Z, BORNSTEIN J, et al. Report on the short endoscopic exocrine pancreatic function test in children and young adults[J]. Pancreas, 2020, 49(5): 642-649. DOI: 10.1097/MPA.0000000000001540.
    [16] CONWELL DL, ZUCCARO G, MORROW JB, et al. Cholecystokinin- stimulated peak lipase concentration in duodenal drainage fluid: A new pancreatic function test[J]. Am J Gastroenterol, 2002, 97(6): 1392-1397. DOI: 10.1111/j.1572-0241.2002.05675.x.
    [17] LIEB JG 2nd, DRAGANOV PV. Pancreatic function testing: Here to stay for the 21st century[J]. World J Gastroenterol, 2008, 14(20): 3149-3158. DOI: 10.3748/wjg.14.3149.
    [18] KELLER J, LAYER P, BRVCKEL S, et al. 13C-mixed triglyceride breath test for evaluation of pancreatic exocrine function in diabetes mellitus[J]. Pancreas, 2014, 43(6): 842-848. DOI: 10.1097/MPA.0000000000000121.
    [19] LARA LF, TAKITA M, BURDICK JS, et al. A study of the clinical utility of a 20-minute secretin-stimulated endoscopic pancreas function test and performance according to clinical variables[J]. Gastrointest Endosc, 2017, 86(6): 1048-1055. e2. DOI: 10.1016/j.gie.2017.03.1532.
    [20] DEWITT JM, AL-HADDAD MA, EASLER JJ, et al. EUS pancreatic function testing and dynamic pancreatic duct evaluation for the diagnosis of exocrine pancreatic insufficiency and chronic pancreatitis[J]. Gastrointest Endosc, 2021, 93(2): 444-453. DOI: 10.1016/j.gie.2020.06.029.
    [21] ERCHINGER F, ENGJOM T, TJORA E, et al. Quantification of pancreatic function using a clinically feasible short endoscopic secretin test[J]. Pancreas, 2013, 42(7): 1101-1106. DOI: 10.1097/MPA.0b013e3182847a86.
    [22] ABU-EL-HAIJA M, CONWELL DL. Pancreatic insufficiency: What is the gold standard?[J]. Gastrointest Endosc Clin N Am, 2018, 28(4): 521-528. DOI: 10.1016/j.giec.2018.05.004.
    [23] CHAMOKOVA B, BASTATI N, POETTER-LANG S, et al. The clinical value of secretin-enhanced MRCP in the functional and morphological assessment of pancreatic diseases[J]. Br J Radiol, 2018, 91(1084): 20170677. DOI: 10.1259/bjr.20170677.
    [24] CHEN JY, WANG ZQ. Clinical application and current status of Secretin-Stimulated Magnetic Resonance Imaging in diagnosis of pancreatic disease[J]. J Clin Radiol, 2020, 39(11): 2343-2346. DOI: 10.13437/j.cnki.jcr.2020.11.045.

    陈井亚, 王中秋. 促胰液素-激发胰腺MRI成像在胰腺病变中的应用及研究进展[J]. 临床放射学杂志, 2020, 39(11): 2343-2346. DOI: 10.13437/j.cnki.jcr.2020.11.045.
    [25] HAFEZI-NEJAD N, SINGH VK, FAGHIH M, et al. Jejunal response to secretin is independent of the pancreatic response in secretin-enhanced magnetic resonance cholangiopancreatography[J]. Eur J Radiol, 2019, 112: 7-13. DOI: 10.1016/j.ejrad.2018.12.024.
    [26] SWENSSON J, ZAHEER A, CONWELL D, et al. Secretin-Enhanced MRCP: How and Why-AJR expert panel narrative review[J]. AJR Am J Roentgenol, 2021, 216(5): 1139-1149. DOI: 10.2214/AJR.20.24857.
    [27] SOUZA D, ALESSANDRINO F, KETWAROO GA, et al. Accuracy of a novel noninvasive secretin-enhanced MRCP severity index scoring system for diagnosis of chronic pancreatitis: Correlation with EUS-based Rosemont criteria[J]. Radiol Med, 2020, 125(9): 816-826. DOI: 10.1007/s11547-020-01181-3.
    [28] ERTURK SM, ICHIKAWA T, MOTOSUGI U, et al. Diffusion-weighted MR imaging in the evaluation of pancreatic exocrine function before and after secretin stimulation[J]. Am J Gastroenterol, 2006, 101(1): 133-136. DOI: 10.1111/j.1572-0241.2006.00406.x.
    [29] MERKLE EM, BAILLIE J. Exocrine pancreatic function: evaluation with MR imaging before and after secretin stimulation[J]. Am J Gastroenterol, 2006, 101(1): 137-138. DOI: 10.1111/j.1572-0241.2006.00400.x.
    [30] MADZAK A, ENGJOM T, WATHLE GK, et al. Secretin-stimulated MRI assessment of exocrine pancreatic function in patients with cystic fibrosis and healthy controls[J]. Abdom Radiol (NY), 2017, 42(3): 890-899. DOI: 10.1007/s00261-016-0972-8.
    [31] ITO K, TORIGOE T, TAMADA T, et al. The secretory flow of pancreatic juice in the main pancreatic duct: Visualization by means of MRCP with spatially selective inversion-recovery pulse[J]. Radiology, 2011, 261(2): 582-586. DOI: 10.1148/radiol.11110162.
    [32] YASOKAWA K, ITO K, KANKI A, et al. Evaluation of pancreatic exocrine insufficiency by cine-dynamic MRCP using spatially selective inversion-recovery (IR) pulse: Correlation with severity of chronic pancreatitis based on morphological changes of pancreatic duct[J]. Magn Reson Imaging, 2018, 48: 70-73. DOI: 10.1016/j.mri.2017.12.007.
    [33] BASHAW H, BROWNELL JN, SCHALL JI, et al. Measures of dietary fat and energy absorption in healthy adults[J]. Pancreas, 2020, 49(6): 845-854. DOI: 10.1097/MPA.0000000000001587.
    [34] van de KAMER JH, TEN BOKKEL HUININK H, WEYERS HA. Rapid method for the determination of fat in feces[J]. J Biol Chem, 1949, 177(1): 347-355.
    [35] VOLMER M, KINGMA AW, BORSBOOM PC, et al. Investigation of applicability of a mid-infrared spectroscopic method using an attenuated total reflection accessory and a new near-infrared transmission method for determination of faecal fat[J]. Ann Clin Biochem, 2001, 38(Pt 3): 256-263. DOI: 10.1258/0004563011900489.
    [36] KORPI-STEINER NL, WARD JN, KUMAR V, et al. Comparative analysis of fecal fat quantitation via nuclear magnetic resonance spectroscopy (1H NMR) and gravimetry[J]. Clin Chim Acta, 2009, 400(1-2): 33-36. DOI: 10.1016/j.cca.2008.10.001.
    [37] LINDKVIST B, PHILLIPS ME, DOMÍNGUEZ-MUÑOZ JE. Clinical, anthropometric and laboratory nutritional markers of pancreatic exocrine insufficiency: Prevalence and diagnostic use[J]. Pancreatology, 2015, 15(6): 589-597. DOI: 10.1016/j.pan.2015.07.001.
    [38] SCHOELLER DA, SCHNEIDER JF, SOLOMONS NW, et al. Clinical diagnosis with the stable isotope 13C in CO2 breath tests: Methodology and fundamental considerations[J]. J Lab Clin Med, 1977, 90(3): 412-421.
    [39] DOMINGUEZ-MUÑOZ JE. Diagnosis and treatment of pancreatic exocrine insufficiency[J]. Curr Opin Gastroenterol, 2018, 34(5): 349-354. DOI: 10.1097/MOG.0000000000000459.
    [40] DOMÍNGUEZ-MUÑOZ JE, NIETO L, VILARIÑO M, et al. Development and diagnostic accuracy of a breath test for pancreatic exocrine insufficiency in chronic pancreatitis[J]. Pancreas, 2016, 45(2): 241-247. DOI: 10.1097/MPA.0000000000000434.
    [41] DOMÍNGUEZ-MUÑOZ JE, IGLESIAS-GARCÍA J, VILARIÑO-INSUA M, et al. 13C-mixed triglyceride breath test to assess oral enzyme substitution therapy in patients with chronic pancreatitis[J]. Clin Gastroenterol Hepatol, 2007, 5(4): 484-488. DOI: 10.1016/j.cgh.2007.01.004.
    [42] ISHII Y, KOHNO T, ITO A, et al. Measurement of extra-pancreatic secretory function by 13C-dipeptide breath test[J]. Transl Res, 2007, 149(6): 298-303. DOI: 10.1016/j.trsl.2006.12.004.
    [43] PIMENTEL M, SAAD RJ, LONG MD, et al. ACG clinical guideline: Small intestinal bacterial overgrowth[J]. Am J Gastroenterol, 2020, 115(2): 165-178. DOI: 10.14309/ajg.0000000000000501.
    [44] VUJASINOVIC M, VALENTE R, DEL CHIARO M, et al. Pancreatic exocrine insufficiency in pancreatic cancer[J]. Nutrients, 2017, 9(3): 183. DOI: 10.3390/nu9030183.
    [45] SIMRÉN M, STOTZER PO. Use and abuse of hydrogen breath tests[J]. Gut, 2006, 55(3): 297-303. DOI: 10.1136/gut.2005.075127.
    [46] SAKAI D, HIROOKA Y, KAWASHIMA H, et al. Increase in breath hydrogen concentration was correlated with the main pancreatic duct stenosis[J]. J Breath Res, 2018, 12(3): 036004. DOI: 10.1088/1752-7163/aaaf77.
    [47] HUA J, YE H, ZHOU Z, et al. Diagnosis of chronic pancreatic injury by hydrogen breath test and elasticity imaging[J]. Mod Med J China, 2018, 20(6): 39-41. DOI: 10.3969/j.issn.1672-9463.2018.06.010.

    华军, 叶红, 周政, 等. 氢呼气试验和弹性成像对慢性胰腺损伤的诊断[J]. 中国现代医药杂志, 2018, 20(6): 39-41. DOI: 10.3969/j.issn.1672-9463.2018.06.010.
    [48] CASELLAS F, GUARNER L, ANTOLÍN M, et al. Hydrogen breath test with low-dose rice flour for assessment of exocrine pancreatic insufficiency[J]. Pancreas, 2004, 29(4): 306-310. DOI: 10.1097/00006676-200411000-00010.
    [49] GILAT T, BEN HUR H, GELMAN-MALACHI E, et al. Alterations of the colonic flora and their effect on the hydrogen breath test[J]. Gut, 1978, 19(7): 602-605. DOI: 10.1136/gut.19.7.602.
    [50] SCOTTA MS, MARZANI MD, MAGGIORE G, et al. Fecal chymotrypsin: A new diagnostic test for exocrine pancreatic insufficiency in children with cystic fibrosis[J]. Clin Biochem, 1985, 18(4): 233-234. DOI: 10.1016/s0009-9120(85)80046-1.
    [51] WALKOWIAK J, HERZIG KH, STRZYKALA K, et al. Fecal elastase-1 is superior to fecal chymotrypsin in the assessment of pancreatic involvement in cystic fibrosis[J]. Pediatrics, 2002, 110(1 Pt 1): e7. DOI: 10.1542/peds.110.1.e7.
    [52] DOMÍNGUEZ-MUÑOZ JE, HIERONYMUS C, SAUERBRUCH T, et al. Fecal elastase test: Evaluation of a new noninvasive pancreatic function test[J]. Am J Gastroenterol, 1995, 90(10): 1834-1837.
    [53] WALKOWIAK J, GLAPA A, NOWAK JK, et al. Pancreatic Elastase-1 Quick Test for rapid assessment of pancreatic status in cystic fibrosis patients[J]. J Cyst Fibros, 2016, 15(5): 664-668. DOI: 10.1016/j.jcf.2016.05.009.
    [54] VANGA RR, TANSEL A, SIDIQ S, et al. Diagnostic performance of measurement of fecal elastase-1 in detection of exocrine pancreatic insufficiency: Systematic review and meta-analysis[J]. Clin Gastroenterol Hepatol, 2018, 16(8): 1220-1228. e4. DOI: 10.1016/j.cgh.2018.01.027.
    [55] TAKASU A, SHIMOSEGAWA T, SHIMOSEGAWA E, et al. [11C]methionine positron emission tomography for the evaluation of pancreatic exocrine function in chronic pancreatitis[J]. Pancreas, 2001, 22(2): 203-209. DOI: 10.1097/00006676-200103000-00016.
    [56] SHI CG, LIU XH, XIE YX, et al. Research advances in pancreatic exocrine insufficiency secondary to pancreatic cancer[J]. J Clin Hepatol, 2021, 37(4): 982-984. DOI: 10.3969/j.issn.1001-5256.2021.04.057.

    史晨光, 刘晓欢, 谢亚兴, 等. 继发于胰腺癌的胰腺外分泌功能不全的研究进展[J]. 临床肝胆病杂志, 2021, 37(4): 982-984. DOI: 10.3969/j.issn.1001-5256.2021.04.057.
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  • 收稿日期:  2021-08-16
  • 录用日期:  2021-09-26
  • 出版日期:  2022-04-20
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