Serum 7 alpha-hydroxy-4-cholesten-3-one and selenohomocholyltaurine (SeHCAT) whole body retention in the assessment of bile acid induced diarrhoea
Serum 7 alpha-hydroxy-4-cholesten-3-one and selenohomocholyltaurine (SeHCAT) whole body retention in the assessment of bile acid induced diarrhoea
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DOI：
10.1097/00042737-199602000-00005
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发表时间：
1996-02-01
影响因子：
2.1
通讯作者：
Merrick, MV
中科院分区：
文献类型：
--
作者：
Brydon, WG;Nyhlin, H;Merrick, MV
目的：评估血清7 α-羟基-4-异戊烯-3-酮的可靠性（7 α-3 ox-C）与（75）硒代高胆酰牛磺酸全身潴留在胆汁酸性腹泻鉴别诊断中的比较设计：在两个中心对164例慢性腹泻患者进行前瞻性研究（Edinburgh and Sweden）通过测量胆汁酸损失或合成的两种不同的测试：测量7天SeHCAT WBR的SeHCAT测试和反映胆汁酸合成速率的血清7 α-3 ox-C。46例患者的SeHCAT WBR小于10%（19例回肠疾病或切除术，9例特发性胆汁酸诱导腹泻，18例胆汁酸诱导腹泻的其他原因）。所有回肠或特发性疾病患者对治疗均表现出良好的反应，其他组中有13例。在所有回肠疾病/切除术受试者、7例特发性疾病患者和对治疗有反应的其他组所有受试者中，血清7 α-30 x-C升高。118例SeHCAT WBR ≥ 10%的患者中有16例血清7 α 30 xC升高。结论：血清7 α 30 xC阳性预测值为74%。血清7 α-3 ox-C的高阴性预测值（98%）表明该试验可能用于排除该人群中的胆汁酸吸收不良。除两名对治疗有反应的受试者外，所有受试者的血清7 α-30 x-C浓度均升高。通过重复检测提高检测灵敏度的可能性有待进一步研究。血清7 α 3 ox-C与分解率、SeHCAT呈显著正相关（r=0.63，P
Objective: To assess the reliability of serum 7 alpha-hydroxy-4-cholesten-3-one (7 alpha-3ox-C) in the differential diagnosis of bile acid induced diarrhoea by comparison with (75)selenohomocholyltaurine whole body retention (SeHCAT WBR).Design: One hundred and sixty-four patients with chronic diarrhoea were investigated prospectively in two centres (Edinburgh and Sweden) by two different tests which measure bile acid loss or synthesis: the SeHCAT test which measures the 7-day SeHCAT WBR and serum 7 alpha-3ox-C which reflects the rate of bile acid synthesis.Results: Forty-six patients had SeHCAT WBR of less than 10% (19 with ileal disease or resection, nine with idiopathic bile acid induced diarrhoea and 18 with miscellaneous causes for bile acid induced diarrhoea). All patients with ileal or idiopathic disease showed a favourable response to treatment as did 13 of the miscellaneous group. Serum 7 alpha-30x-C was raised in all subjects with ileal disease/resection, seven patients with idiopathic disease and all subjects in the miscellaneous group who responded to treatment. Sixteen out of 118 patients with SeHCAT WBR greater than or equal to 10% had raised serum 7 alpha-3ox-C.Conclusion: The positive predictive value of serum 7 alpha-30x-C was 74%. The high negative predictive value (98%) of serum 7 alpha-3ox-C indicates the possible use of this test for excluding bile acid malabsorption in this population. All but two subjects who responded to treatment had raised serum 7 alpha-30x-C concentrations. The possibility that the sensitivity of the test can be improved by repeat testing needs to be further investigated. There was a significant correlation between fractional catabolic rate (FCR) SeHCAT and serum 7 alpha-3ox-C (r=0.63, P