口服^（13）C-软脂酸诊断乳糜腹水  

DIAGNOSISOFCHYLOUSASCITESWITHORALADMINISTRATIONOF13C┐PALMITICACID

作　　者：王景平[1] 朱峰[1] 潘国宗[1] 江骥[1] 胡玉芳[1] 

机构地区：[1]中国医学科学院北京协和医院消化内科

出　　处：《中华内科杂志》1996年第6期382-384,共3页Chinese Journal of Internal Medicine

摘　　要：近３０年来我院收治的乳糜腹水共１２例。病因中非创伤性占８３．３％，创伤性占１６．７％。所有病例均进行了放射性核素淋巴显像或淋巴管造影检查，８例发现病变部位。但这两种影像学检查不能显示肠干淋巴管病变。利用长链脂肪酸经肠道吸收后直接进入肠干淋巴管这一特点，首次报告用１３Ｃ－软脂酸口服后，连续测定腹水及呼气中１３Ｃ含量来检测肠干淋巴管有无漏出。经过对１例核素淋巴显像及淋巴管造影均未见异常的病人检测结果显示，口服１３Ｃ－软脂酸后３０分钟，腹水中就可测出１３Ｃ，而呼气中１３ＣＯ２阴性，表明乳糜液经肠干淋巴管漏入腹腔。此方法不仅可以确定肠干淋巴管的漏出，且有助于判断漏出部位和阻塞程度，其临床诊断价值较高，为乳糜腹水治疗方案的选择提供了可靠的依据。casesofchylousascitesinPUMChospitalintherecent30yearswereanalysed.Theetiologyofthisdiseaseincludesnon-traumatic(83.3%)andtraumatic(16.7%)causes.Althepa-tientsreceivedisotopeexaminationorlymphangiography,butonlyin8patientsthesiteofthelesionwasfound.Asthesetwokindsofexaminationcanonlyshowthelesionsintherightandleftlumbarlymphtrunks,cisternachyliandthroacicductbutnottheintestinallymphtruck,theauthorssetupamethodbyadministeringoraly13C-palmiticacidtodetectthelesionofintestinallymphtrunk.Palmiticacidisalong-chainfatyacid,whichentersdirectlyintotheintestinallymphtrunkafterab-sorption.Palmiticacidlabeledwith13Ccouldbedetectedintheasciticfluidifthereisaleakfromin-testinallymphtrunk.Thisnewmethodwasusedtoexamineapatientswhohadnegativeresultswithisotopeexaminationandlymphangiography;13Ccouldbedetectedintheasciticfluid30minutesafteroraladministrationbutnotinexhaledair.Itcanbeconcludedthatcyhleleakedintotheperitonealcavi-tyfromtheintestinallymphtrunk.Thismethodisalsoofhelptodeterminethepossiblesiteofleakageandthedegreeofobstruction,soitisquiteusefulforthediagnosisofchylousascities.

关 键 词：乳糜腹水 诊断 同位素标记 碳13 软脂酸 

分 类 号：R442.5[医药卫生—诊断学]