Kinetic Test of Pancreatic Exocrine Function

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In order to improve the diagnostic evaluation of pancreatic exocrine function, 75Se-activity in duodenal aspirate was measured after an intravenous injection of 75Se-selenomethionine, twenty control subjects and 111 subjects with pancertic and/or gastrointestinal disease were studied. Pancreozymin-Secretin test (PStest) was started 20min. after i.v. injection of 75Se-selenomethionine, and duodenal contents were fractionally collected up to 130min. The radioactivity in the duodenal aspirate of the control subjects remained low until 80min. It then rose rapidly and reached a plateau at 115min. In contrast, the radioactivity in the subjects with pancreatic disease remained low, or rose only slowly throughout the period of collection. The radioactivity of the protein fraction (TCA-precipitable) in the 80 to 130min. duodenal aspirate gave good separation between controls and subjects with pancreatic disease. The incidence of abnormalities of TCA-precipitable radioactivity in the 80 to 130min. duodenal aspirate was significantly higher than that of the conventional PS-test parameters in groups with various pancreatic diseases. All of the subjects having an abnormal maximal ratio of TCA-precipitable radioactivity to protein (representing pancreatic enzyme synthesis) showed an abnormal distribution in output of TCA-precipitable radioactivity in 80 to 130min. collection (representing both enzyme synthesis and excretion). On the other hand, subjects with abnormal output of TCA-precipitable radioactivity in 80 to 130min. could be separated into those with normal and abnormal ratios of TCA-precipitable radioactivity, suggesting the presence of two types of disturbance in pancreatic function. In the latter group both synthesis and secretion of enzyme are impaired. In the former group secretion of enzyme is depressed, although enzyme synthesis is fairly well preserved. From these results we consider that determination of 75Se-activity in the 80 to 130min. duodenal aspirate may provide a sensitive test for pancreatic function particularly useful in detecting pancreatic disease in the early stages. In addition these data suggest that tow pancreatic function, i.e. synthesis and excretion of enzyme can be measured separately by this method.
財団法人日本消化器病学会の論文

Kinetic Test of Pancreatic Exocrine Function

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