13C-美沙西定呼气试验评估肝硬化患者肝储备功能的研究

目的探讨13C-美沙西定呼气试验评估肝硬化患者肝储备功能的临床价值。方法随机选取健康志愿者30例为对照组,肝硬化患者82例为试验组,服用13C-美沙西定75mg后,通过呼气质谱仪检测10个时间段呼出的13CO2含量,得出DOB曲线、MV曲线及CUM曲线,MVmax30、CUM30及CUM120值,并与常规肝功能生化指标及Child-Pugh分级行相关性分析。结果MVmax30、CUM30及CUM120值在对照组及肝硬化ChildA、B、C各组间,除ChildA、B组的CUM120值外,均有显著性差异(P<0·05),MVmax30、CUM30及CUM120值与部分肝功能生化指标及Child-Pugh分级计分有相关性。结论13C-美沙西定呼气试验是1种定量评估肝硬化患者肝储备功能的有效方法。     

13C-嘧噻西叮呼气试验对肝脏储备功能的诊断价值

目的探讨^13C-嘧噻西叮呼气试验用于肝脏储备功能检测的临床价值。方法将69例肝硬化患者分为Child A、B、C三组,另设7例为对照组。采集受试者不同时间点的呼气标本并检测^13C丰度,绘制丰度（delta over baseline,DOB）曲线、代谢速率（metabolisation velocity,MV）曲线和累积丰度（cumulated dose,CUM）曲线。结果随着Child—Pugh分级的升高,DOB、MV峰值出现时间延长,峰值降低（P〈0．05）,CUM曲线趋于低平;参数与部分常规肝功能检查呈相关性（P〈0．05）。结论^13C-嘧噻西叮呼气试验能够有效地反映肝细胞损伤情况和肝脏储备功能。     

IRIS13 C-美沙西汀呼气试验在肝硬化患者中的应用及评价

目的 探讨13 C-美沙西汀呼气试验在评估肝硬化患者肝功能状况中的临床应用价值.方法 42例肝硬化患者,根据传统child-Pugh分级分为A、B、C三组.均做常规肝功能生化检测及3C-美沙西汀呼气试验.结果 随着Child-Pugh分级的加重,呼气试验参数值MVmax40(40分钟前代谢速率峰值与正常值(27)的比值)、CUM40(40分钟CO2累积呼出丰度与正常值(12)的比值)和CUM120(120分钟C02累积呼出丰度与正常值(28)的比值)显著降低,组间差异有显著性(P＜0.05).三参数值与Child-Pugh分级计分及一些临床肝功能检测结果显著相关(P＜0.05).结论 IRIS13C(红外线同位素12C)-美沙西汀呼气试验能准确反应肝脏储备和代偿功能,是传统Child-Pugh分级及临床肝功能生化检测评估肝功能的有益补充,具有即时、安全、有效、定量、无创的特点.     

^13C-嘧塞西啶呼气试验测量肝脏储备功能的临床研究

目的 探讨^13C-嘧塞西啶呼气试验与肝脏储备功能分级的关系。方法 10名健康志愿者和30例各种肝病病人分为肝功能正常组及Child-Pugh A、B、C组，每组10例；每人均做血生化、肝功能检测并空腹口服^13C-嘧塞西啶75mg后，在120min内9个时间点收集呼出气体，利用呼气质谱仪测出DOB值及CL／M30和CUM120数值。结果 在肝功能正常组及Child-Pugh A、B、C组中的肝脏功能的诸项指标中，血清白蛋白(ALB)、前白蛋白(PreALB)、血色素(Hb)、血小板(PLT)水平逐渐下降；总胆红素(TBIL)、直接胆红素(DBIL)、总胆汁酸(TBA)水平逐渐升高；并且具有统计学意义。肝功能正常组及Child-PughA、B、C组中^13C-嘧塞西啶呼气试验累积丰度(CUM30，CUM130)水平逐渐下降，并且差异具有统计学意义。结论 ^13C-嘧塞西啶呼气试验是评价肝病病人肝脏功能的安全有效的诊断方法。     

13C-美沙西丁呼气试验对亚临床肝性脑病的临床价值分析

目的探讨13C-美沙西丁呼气试验对亚临床肝性脑病(SHE)发病率和预后判断等方面的临床应用价值.方法随机选择72例肝硬化患者和31例正常人作为研究对象,对所有受试者进行数字连接试验和智商(IQ)检测,以明确有无SHE,并同步进行13C-美沙西丁呼气试验、血氨等检测.比较13C-美沙西丁呼气试验的肝功能分级与临床Child Pugh分级的关系;采用多因素相关分析,比较13C-美沙西丁呼气试验的分级指标、血氨指标对并发SHE的关系;随访所有肝硬化患者的13C-美沙西丁呼气试验分级结果与SHE的关系.结果肝硬化患者13C-美沙西丁呼气试验的肝功能分级与临床Child Pugh分级的差别无统计学意义(P＞0.05).13C-美沙西丁呼气试验分级为病理性肝损害、Child Pugh A级的两组肝硬化患者中无SHE,SHE患者均出现在13C-美沙西丁呼气试验分级为Child B级或Child C级且血氨值为(90.56±13.66)μmol/L或更高的患者中.在肝硬化患者13C-美沙西丁呼气试验的肝功能分级中,Child C级中SHE的发病率高于Child B级(P＜0.05).随访发现,13C-美沙西丁呼气试验为Child B级和Child C级患者存在并发SHE的危险.结论13C-美沙西丁呼气试验可作为SHE发病的重要评判因素之一并有助于对肝硬化并发SHE的预后判断.     

13C-美沙西丁呼气试验联合血清胰岛素样生长因子及其结合蛋白测定对肝硬化患者肝功能状况的评估

目的 探讨13C-美沙西丁呼气试验联合血清胰岛素样生长因子-1(insulin like growth factor-1,IGF-1)、胰岛素样生长因子结合蛋白.3(insulin-like growth factor binding protein-3,IGFBP-3)测定对肝硬化患者肝功能状况评估的临床意义.方法随机选取肝炎后肝硬化14例,隔夜空腹,服用13C-美沙西丁75 mg后,通过13C红外线能谱分析仪检测10个时间段呼出碳13的含量,得出Mvmax40(40分钟前13C代谢速率峰值与正常值的比值)、CUM 40(40分钟13CO2累积呼出丰度与正常值的比值)及CUM 120(120分钟13CO2累积呼出丰度与正常值的比值),并同步采用免疫放射法定量测定血清IGF-1、IGFBP-3水平.结果肝硬化患者Mvmax 40、CUM 40、CUM 120值,在Child A、B、C各组间,除A组与B组的CUM 120值外,差异有显著性(P＜0.05).IGF-1,IGFBP-3值在Child A、B、C组间除Child A组与B组间外,差异有显著性(P＜0.05).13C Mvmax 40、CUM40、CUM 120及IGF-1、IGFBP-3值与Child pugh积分呈明显负相关(r-0.881,-0.878,-0.833,-0.700,-0.815),13C Mvmax 40、CUM 40、CUM 120值与IGF-1、IGFBP-3值呈明显正相关.结论13C美沙西丁肝功能呼气试验能对即时的肝细胞贮备功能及代偿功能进行量化评估,结合IGF-1、IGFBP-3检测,是对临床传统方法肝功能判断的有益补充.     

^13C-美沙西丁呼气试验和吲哚氰绿清除试验对急性肝损害大鼠肝功能评价的比较

目的对比研究^13C-美沙西丁呼气试验（^13C—MBT）及吲哚氰绿清除试验在急性肝损害肝功能评估中的价值。方法48只SD大鼠随机分为对照组和模型组,对照组给予腹腔注射生理盐水;模型组分为6、12、24、48、72h组,腹腔注射D-氨基半乳糖诱导急性肝损害模型。观察各组肝组织病理学、吲哚氰绿15min滞留率（ICGR15）、^13C—MBT相关参数：包括^13CO2峰度曲线达峰时间（Tmas）、代谢速率峰值（MVmax）、120min^13CO2累积呼出丰度（CUM120）和呼气峰值（DOBmax）的变化。组间比较采用单因素方差分析,多个样本均数两两比较采用SNK—q检验,两变量间的关系采用Pearson相关分析。结果与对照组比较,模型组各组病理学积分明显升高（P〈0．05）,DOBmax、MVmax40和CUM120明显降低（P〈0．05）。病理积分与Tmax呈正相关（r=0．593,P〈0．05）,与MVmax、CUM120和DOBmax呈负相关（相关系数分别为-0．731、-0．618、-0．592,P〈0．01）。与对照组比较,12、24、48h组ICGRl5明显升高（P〈0．05）,6、12h组与对照组ICGR15差异无统计学意义（P〉0．05）。结论^13C—MBT及ICGR15均能动态地反映急性肝损害的病理状况,^13C—MBT在急性肝损害的早期诊断方面较ICG清除试验更敏感。     

IRIS13C-美沙西汀呼气试验对肝功能检测临床价值与预后评估

目的探讨红外线同位素能谱分析仪(IRIS)13C-美沙西汀呼气试验在肝硬化肝功能分级及预后评估应用中的价值.方法选取肝硬化患者59例作为研究对象,健康志愿者12例作为正常对照组,进行13C-美沙西汀呼气试验肝功能检测并与Child-pugh肝功能分级进行比较,随访半年观察病情预后.结果①13C-美沙西汀呼气试验mvmax40值、cum40值及cum120值在对照组、Child-pugh A、B、C组间依次降低,组间差异均有显著性(P＜0.01),且与Child-pugh肝功能分级具有显著负相关性(r值分别为-0.562,-0.614和-0.716,P＜0.001).②13C-美沙西汀呼气试验与Child-pugh肝功能分级判定肝硬化患者肝功能状况具有一致性(Kappa=0.69,P＜0.05).③预后:13C-分级为一级(包括亚病理性肝损害3例)22例均预后良好;13C-分级为二级的14例中,2例死于上消化道大出血;13C-分级为三级的11例中5例分别先后死于肝昏迷、肝肾综合征及感染性休克.结论13C-美沙西汀呼气试验作为一种灵敏、定量的肝功能试验可用于肝硬化患者的肝功能状况分级并有助于本病手术选择与预后评估.     

ICGR15在肝硬化断流术前评估肝脏储备功能的应用价值

目的 探讨吲哚菁绿试验15 min滞留率(ICGR15)在评估肝硬化断流术前肝脏储备功能的应用价值.方法 回顾性分析我院收治的75例肝硬化行断流术的患者,Child - Pugh A级患者55例,Child - Pugh B级患者20例.手术方式均为贲门周围血管离断术.对Child - Pugh A、B级两组患者术前测定的ICGR15及肝功能良好组和肝功能不全组间年龄、ALT、TBil、PT、Alb、ICGR15值、Child - Pugh评分进行比较,并应用ROC曲线评价ICGR15值的评估价值.结果 Child - Pugh A、B级两组ICGR15值分别为(17.98±12.12)％、(34.19 ±9.90)％,两组间差异具有统计学意义(P＜0.01);肝功能良好组和肝功能不全组间ICGR15值、Child - Pugh评分差异存在统计学意义(P＜0.01),年龄、ALT、TBil、PT、Alb差异无统计学意义(P＞0.01);ROC曲线下面积为0.971,差异有统计学意义(P =0.000).结论 ICGR15值是肝硬化断流术前评估肝脏储备功能较好的指标.     

IRIS 13C-美沙西汀呼气试验对肝硬化患者肝功能状况临床价值分析

目的:探讨13C-美沙西汀呼气试验(13C-MBT)对肝硬化患者的临床应用价值。方法:选取116例肝硬化患者作为观察对象,常规行肝功能检查,进行13C-MBT肝功能检测并与Child-Pugh临床分级进行比较。对所有研究对象随访半年,观察预后。结果:随着Child-Pugh分级的加重,DOB、MV峰值逐渐降低,峰值时间明显延长,13C-MBT的MVmax40、CUM40和CUM120值随着肝功能损害的加重而显著降低,组间的差异有显著性(P<0.05),PT、TBA与DOB、MV峰值时间呈正相关,与其余参数呈负相关;ALB与DOB、MV峰值时间呈负相关,与其余参数呈正相关。13C-MBT肝功能分级与传统的Child-Pugh临床分级具有一致性(Kappa值0.72,P<0.05)。随访的结果显示,13C-MBT分级A级的患者无观察对象死于肝脏相关的疾病,B级患者3例死亡,死亡率为7.9%,而13C-MBTC级患者的死亡率高达38.1%,患者先后死于上消化道出血、肝性脑病、肝肾综合征、腹膜炎等。结论:13C-MBT是一种有效的肝硬化肝功能分级方法,能够准确反映肝细胞损伤情况和肝脏的储备功能,可用于评估肝硬化患者肝功能状况和预后判断。     

Measurement of hepatic functional mass by means of ^13C-methacetin and 13C-phenylalanine breath tests in chronic liver disease： Comparison with Child-Pugh score and serum bile acid levels

AIM: To evaluate and compare the clinical usefulness of ~(13)C-phenylalanine and ~(13)C-methacetin breath tests in quantitating functional hepatic mass in patients with chronic liver disease and to further compare these results with those of conventional tests, Child-Pugh score and serum bile acid levels. METHODS: One hundred and forty patients (50 HCV-related chronic hepatitis, 90 liver cirrhosis patients) and 40 matched healthy controls were studied. Both breath test and routine liver test, serum levels of cholic and chenodeoxycholic acid conjugates were evaluated. RESULTS: Methacetin breath test, expressed as 60 min cumulative percent of oxidation, discriminated the hepatic functional capacity not only between controls and liver disease patients, but also between different categories of chronic liver disease patients. Methacetin breath test was correlated with liver function tests and serum bile acids. Furthermore, methacetin breath test, as well as serum bile acids, were highly predictive of Child-Pugh scores. The diagnostic power of phenylalanine breath test was always less than that of methacetin breath test. CONCLUSION: Methacetin breath test represents a safe and accurate diagnostic tool in the evaluation of hepatic functional mass in chronic liver disease patients.     

[13C]methacetin breath test for evaluation of liver damage

Methacetin undergoes rapid O-dealkylation by hepatic microsomal enzyme systems, and the resultant CO2 is present in the expired air. The rate of O-dealkylation of methacetin was assessed by the [13C]methacetin breath test in seven healthy volunteers and 30 patients with histologically proven chronic liver diseases. The 30-min recovery of orally administered [13C]methacetin as 13CO2 in the exhaled air was significantly reduced in patients with chronic aggressive hepatitis and in those with liver cirrhosis but not in patients with chronic persistent hepatitis or healthy controls. Patients with either advanced cirrhosis or hepatocellular carcinoma showed significantly lower values than those with well-compensated cirrhosis. The levels in two patients with late primary biliary cirrhosis were reduced. These results show that the severity of liver damage can be effectively evaluated by [13C]methacetin breath test. In addition, this test is simple, safe, and time efficient.     

13C-methacetin and 13C-galactose breath tests can assess restricted liver function even in early stages of primary biliary cirrhosis

OBJECTIVE: The 13C-methacetin breath test quantitatively evaluates cytochrome P450-dependent liver function. The 13C-galactose breath test non-invasively measures the galactose oxidation capacity of the liver. The aim of this study was to find out whether these breath tests are sensitive parameters also in non-cirrhotic patients with primary biliary cirrhosis. MATERIAL AND METHODS: Nineteen patients with early-stage primary biliary cirrhosis (no cirrhotic alterations in the liver biopsy, Ludwig stage I-III) and 20 healthy controls underwent the 13C-methacetin and 13C-galactose breath tests. RESULTS: Patients with primary biliary cirrhosis metabolized less 13C-methacetin than controls (cumulative recovery within 30 min 7.5+/-2.4% versus 14.0+/-2.6%; p < 0.001). When a cut-off > 9.8% was used for the cumulative recovery after 30 min, the methacetin breath test reached 84.2% sensitivity and 95.0 specificity. In the 13C-galactose breath test, the percentage recovery at 60 min in patients was 3.1+/-1.3%/h, and 6.3+/-1.1%/h in controls (p < 0.001). Using a cut-off > 4.7%/h, the galactose breath test reached 89.5% sensitivity and 95.0 specificity. CONCLUSIONS: In non-cirrhotic, early-stage, primary biliary cirrhosis the 13C-methacetin breath test and the 13C-galactose breath test reliably indicate decreased liver function. The 13C-galactose breath test can also predict the histological score.     

13C-methacetin breath test in chronic hepatitis C liver disease

BACKGROUND: The 13C-methacetin breath test is a non-invasive method to evaluate hepatic microsomal function that allows a quantitative assessment of the functional hepatic mass. AIM: To evaluate the clinical usefulness of the 13C-methacetin breath test in patients with hepatitis C chronic liver disease. PATIENTS AND METHODS: Seventy eight patients with chronic hepatitis C and 13 matched healthy controls were studied. HCV patients were classified as having chronic hepatitis (n = 51), cirrhosis (n = 27), being seven with decompensated disease (presence of ascite, jaundice and/or encephalopathy). HbsAg/HIV co-infected patients, chronic alcohol drinker, having other chronic diseases and those using drugs that could interfere with hepatic cytochrome P450, were excluded. The disease stage and activity in biopsy fragments were determined according the Brazilian Society of Hepatology criteria. Breath test was performed with 75 mg of 13C-methacetin, and the 13CO2 in the expired air was measured through a nondispersive infra red spectrometry. The delta over baseline, and the cumulative recovery of 13CO2 at 40 (13C-methacetin breath test 40 min) and 120 minutes (13C-methacetin breath test 120 min) were calculated. RESULTS: 13C-methacetin breath test parameters correlate only with hepatic staging but not with necroinflammatory (activity) parameters, being the best correlation found between hepatic staging and the 13C-methacetin breath test 120 minutes. The mean values for 13C-methacetin breath test 120 min was significantly reduced in the cirrhotic groups (19.2 +/- 7.1% for compensated and 14.7 +/- 4.0% for decompensated cirrhotics) than in control (29.9 +/- 4.5%) and chronic hepatitis (27.8 +/- 6.1%) groups. The best diagnostic accuracy for the diagnosis of cirrhosis among HCV patients was found for 13C-methacetin breath test 120 min with 81% of sensibility and 77% of specificity. CONCLUSION: 13C-methacetin breath test is correlated with structural changes in HCV-related chronic hepatic diseases and the cumulative recovery at 120 minutes is a sensitive parameter to identify the presence of hepatic cirrhosis in these patients.     

Utility of a 13C‐methacetin breath test in evaluating hepatic injury in rats

Background and Aim: Methacetin is thought to be a good substrate for the evaluation of different cytochrome P450 enzymatic systems of liver microsomes because of its rapid metabolism and lack of toxicity in small doses. Recent studies indicate that a methacetin breath test may be a non‐invasive alternative for the evaluation of liver function since it correlates well with the severity of liver damage. It may also discriminate between different stages of liver cirrhosis and correlates with the Child–Pugh score. The application of this test in experimental liver damage in animal models has not yet been examined. This study aimed to evaluate the efficacy of the ¹³C‐methacetin breath test in assessing the extent of hepatic injury in models of acute liver failure, liver cirrhosis, and fatty liver in rats. Methods: Absorption of methacetin given per os or intraperitoneally in normal rats was evaluated. The association between liver mass and ¹³C‐methacetin breath test results was assessed in a 70% hepatectomy rat model. Fulminant hepatic failure was induced by three consecutive intraperitoneal injections of thioacetamide, 300 mg/kg, at 24 h intervals. For induction of liver cirrhosis, rats were given intraperitoneal injections of thioacetamide, 200 mg/kg, twice a week for 12 weeks. A methionine‐choline deficient diet was used for the induction of fatty liver. Rats were analyzed for ¹³C‐methacetin by BreathID (MBID) using molecular correlation spectrometry. BreathID continuously sampled the animal's breath for 60 min and displayed the results on the BreathID screen in real‐time. Results: Methacetin was absorbed well irrespective of the administration method in normal rats. Liver mass was associated with peak amplitude, complete percent dose recovery (CPDR) at 30 and 60 min and MBID peak time. A high degree of association was also demonstrated with MBID results in acute hepatitis (peak amplitude, 19.6 ± 3.4 vs 6.3 ± 1.63.4; CPDR30, 6.0 ± 3.3 vs 1.2 ± 0.5; CPDR60, 13.3 ± 4.5 vs 3.2 ± 1.4; and peak time, 31.0 ± 14.9 vs 46.9 ± 10.8 min) and liver cirrhosis (peak amplitude, 24.4 ± 2.3 vs 15.6 ± 6.4; CPDR30, 7.9 ± 1.2 vs 2.7 ± 1.0; CPDR60, 17.8 ± 2.6 vs 8.8 ± 2.1; and peak time, 30.2 ± 1.5 vs 59.6 ± 14.5 min), but not with grade of liver steatosis. Conclusions: Methacetin is well absorbed and exclusively metabolized in the liver. MBID is a sensitive test and may be a useful tool for the evaluation of functional liver mass in animal models of acute liver failure and cirrhosis. However, MBID could not distinguish between fatty liver and normal liver in rats.     

Liver involvement in hereditary hemorrhagic telangiectasia: can breath test unmask impaired hepatic first-pass effect?

Hepatic arteriovenous malformations (HAVMs) in hereditary hemorrhagic telangiectasia (HHT) have long been considered to have scarce clinical significance in most cases. Nevertheless, data are lacking regarding the influence of HAVMs on the liver first-pass effect on drugs in HHT patients. To gain insight into the effect of HAVMs on hepatic drug clearance by means of two specific ¹³C-labeled probes, namely the ¹³C-methacetin and ¹³C-aminopyrine, 46 HHT patients and 44-matched healthy controls were enrolled. The liver first-pass effect was studied by the ¹³C-based breath test using methacetin and aminopyrine. The methacetin breath test showed statistically significant reduced metabolism rates (p?<?0.0001) in HHT when compared with controls, both in patients with and without CT-detectable HAVMs, and when expressed both as cumulative ¹³C-percentage dose per hour and as ¹³C-percentage peak after 15?min. In contrast, no significant difference was found between HHT and controls regarding aminopyrin metabolism rates. In HHT, ¹³C%-methacetin breath test values are significantly lower than those found in normal subjects, probably due to the effect of hepatic shunts. A reduced perfusion and an impaired hepatic metabolism might affect hepatic drug clearance in HHT. Therefore, an appropriate dosage adjustments should be considered when high-hepatic-metabolism drugs are administered to HHT patients.     

13C-methacetin and 13C-galactose breath tests can assess restricted liver function even in early stages of primary biliary cirrhosis

Objective. The ¹³C-methacetin breath test quantitatively evaluates cytochrome P450-dependent liver function. The ¹³C-galactose breath test non-invasively measures the galactose oxidation capacity of the liver. The aim of this study was to find out whether these breath tests are sensitive parameters also in non-cirrhotic patients with primary biliary cirrhosis.

Material and methods. Nineteen patients with early-stage primary biliary cirrhosis (no cirrhotic alterations in the liver biopsy, Ludwig stage I–III) and 20 healthy controls underwent the ¹³C-methacetin and ¹³C-galactose breath tests.

Results. Patients with primary biliary cirrhosis metabolized less ¹³C-methacetin than controls (cumulative recovery within 30 min 7.5±2.4% versus 14.0±2.6%; p<0.001). When a cut-off?>?9.8% was used for the cumulative recovery after 30 min, the methacetin breath test reached 84.2% sensitivity and 95.0 specificity. In the ¹³C-galactose breath test, the percentage recovery at 60 min in patients was 3.1±1.3%/h, and 6.3±1.1%/h in controls (p<0.001). Using a cut-off?>?4.7%/h, the galactose breath test reached 89.5% sensitivity and 95.0 specificity.

Conclusions. In non-cirrhotic, early-stage, primary biliary cirrhosis the ¹³C-methacetin breath test and the ¹³C-galactose breath test reliably indicate decreased liver function. The ¹³C-galactose breath test can also predict the histological score.     

^13C-乙酰胺甲氧基苯呼气试验在肝功能评估中的作用

临床上欲了解肝病的病变程度通常需要评估肝功能，然而目前临床上仍缺乏安全、简便、准确、特异性好、重复性佳的肝功能检测手段。^13C-乙酰胺甲氧基苯呼气试验（MBT）能定量评估细胞色素P450酶系统。以MBT评估组织学证实慢性肝病患者的乙酰胺甲氧基苯的O-脱烃作用，能准确反映肝损伤程度。MBT可区分早期肝硬化（Child—PughA）和无肝硬化患者。本文就MBT在肝功能评估中的作用作一综述。     

13C-methacetin breath test shortened: 2-point-measurements after 15 minutes reliably indicate the presence of liver cirrhosis

BACKGROUND AND GOALS: The 13C-methacetin breath test (MBT) measures the activity of the cytochrome P450 dependent enzyme system and has been developed to assess the functional hepatic mass. We evaluated simple modifications of the 13C-MBT to further increase its practicability and therefore clinical acceptance. STUDY: One hundred and four patients with different chronic liver diseases (including 35 patients with histologically proven cirrhosis) and 65 healthy controls underwent the 13C-MBT. Breath test results of 2-point measurements were compared with conventional breath test results (cumulative recovery after 30 min) and liver histology. RESULTS: The 2-point-measurement at 0 and 15 minutes (with a cut-off <14.6 per thousand delta over baseline) had 92.6% sensitivity and 94.1% specificity in identifying the presence of cirrhosis compared with liver histology. The 2-point-measurements at 5 and 10 minutes also provided good discrimination between cirrhotic and noncirrhotic patients. CONCLUSIONS: The 13C-MBT using 2-point-measurement of breath samples at baseline and after 15 minutes reliably indicates decreased liver function in liver cirrhosis. This simplification of the 13C-MBT will increase practicability and cost efficiency, thus facilitating its clinical acceptability.