The efficiency of endoscopic pancreatic function testing is optimized using duodenal aspirates at 30 and 45 minutes after intravenous secretin
The efficiency of endoscopic pancreatic function testing is optimized using duodenal aspirates at 30 and 45 minutes after intravenous secretin
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DOI：
10.1111/j.1572-0241.2006.00949.x
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发表时间：
2007-02-01
影响因子：
9.8
通讯作者：
Love, Thomas E.
中科院分区：
文献类型：
--
作者：
Stevens, Tyler;Conwell, Darwin L.;Love, Thomas E.
注意事项：内镜分泌素试验（ePFT）需要一个小时才能完成，限制了其常规使用的实用性。我们试图确定哪些时间内镜收集最好的预测峰值碳酸氢盐浓度从完整的一小时长的test.METHODS：一个横断面研究进行了所有ePFT在我们的机构从2000年至2004年。我们比较了7个理论缩短的测试[4-单次采集（促胰液素后15，30，45或60分钟）和3-双次采集（促胰液素后15/30，30/45，45/60分钟）]的完整的测试和彼此使用多元线性和德明回归models.RESULTS：240 ePFT的碳酸氢盐结果进行了分析。基于与完整检测的最接近一致性（94%），双重30/45分钟采集是最佳方法。德明回归显示，从分析角度来看，30/45估计值是最佳组合，因为与参考检测相比，其缺乏显著比例偏倚和最小常数偏倚（5.1 mEq/L）。使用的30/45的方法与调整后的临界点75 mEq/L产生非常好的特异性（93%）的裁决外分泌insufficient.CONCLUSIONS：在30和45分钟的双重定时抽吸可用于筛选胰腺外分泌功能不全的腹痛患者，简化了在临床实践中使用的ePFT。
OBJECTIVES: The endoscopic secretin test (ePFT) takes an hour to perform, limiting its practicality for routine use. We sought to determine which timed endoscopic collections best predict the peak bicarbonate concentration from full hour-long test.METHODS: A cross-sectional study was performed of all ePFTs performed at our institution from 2000 to 2004. We compared 7 theoretical shortened tests [4-single collections (15, 30, 45, or 60 minutes after secretin) and 3-dual collections (15/30, 30/45, 45/60 minutes after secretin)] to the full test and to each other using multivariate linear and Deming regression models.RESULTS: The bicarbonate results of 240 ePFTs were analyzed. The dual 30/45-minute collection was the optimal method based on the closest agreement with the full test (94%). Deming regression reveals the 30/45 estimate to be the best combination from an analytic perspective, owing to its lack of significant proportional bias and minimal constant bias (5.1 mEq/L) as compared to the reference test. Use of the 30/45 method with the adjusted cutpoint 75 mEq/L produces very good specificity (93%) for ruling in exocrine insufficiency.CONCLUSIONS: A dual timed aspiration at 30 and 45 minutes can be used to screen for pancreatic exocrine insufficiency in patients with abdominal pain, simplifying the use of the ePFT in clinical practice.