Ｎ‐ベンゾイル‐Ｌ‐チロシル‐Ｐ‐アミノ安息香酸経口投与によるすい臓外分泌機能検査法の検討

• Published in: Japanese Journal of National Medical Services Vol. 34; no. 8; pp. 736 - 739
• Main Authors: KAWAMURA Hidetoshi, KUROIWA Hideo
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of National Medical Services 1980; 一般社団法人 国立医療学会
• ISSN: 0021-1699; 1884-8729
• DOI: 10.11261/iryo1946.34.736

A synthetic peptide, N-benzoyl-L-tyrosyl-P-aminobenzoic acid (BT-PABA) was orally administered to 10 controls and 25 patients for the exocrine pancreatic function test (PFD test). The BT-PABA is specially cleaved by pancreatic chymotrypsin and releases P-aminobenzoic acid (PABA) which is absorbed from the intestines, conjugated in the liver and excreted in the urine.In the control group a mean of 88.46±6.76% (M±SD) of the PABA was excreted over a period of six hours. The recovery rates of PABA in chronic pancreatitis, suspected chronic pancreatitis, cholelithiasis, cases of partial pancreatectomy were 56.76±24.30%, 71.30±13.53%, 71.22±10.71%, and 42.16±10.90% respectively. These values were statistically significant as compared with that of the control group.The PFD test is simpler and more comfortable to the examinees than the PS test and is useful in the diagnosis of exocrine pancreatic insufficiency, especially in chronic pancre-atitis. More studies will be required to diagnose chronic pancreatitis with mild pancreatic dysfunction. 現在行われている膵外分泌機能検査法PS試験は操作が煩雑であるばかりでなく患者に与える苦痛も少なくない. 合成ペプタイドN-benzoyl-L-tyrosyl-P-aminobenzoic acid (BT-PABA)は膵液中のキモトリプシンで特異的に分解され, P-aminobenzoic acid (PABA)を遊離して腸管より吸収され, 肝で抱合を受けたのち尿中に排泄される. この原理に基づいた膵外分泌機能検査法PFD試験が臨床に用いられるようになつた. BT-PABA500mg経口負荷, 6時間の尿中PABA排泄率の正常下限値は75%であつた.膵疾患, 胆石症の膵外分泌機能を検討した結果, 慢性膵炎, 膵部分切除例で著明な低下がみられたほか, 疾患群のPABA排泄率は正常例に比べ有意の低下を示した. PFD試験は簡便で副作用もなく同時に多数例を行うこともできる. 今後試験食用などで軽症例の診断も可能と考えられ, 有用な膵外分泌機能検査法と考えられる.