Benini L, Caliari S, Bonfante F, Bardelli E, Castellani G, Sembenini C, Brentegani M T, Vantini I
Divisione di Gastroenterologia, Università di Verona, Italia.
Digestion. 1992;53(1-2):94-100. doi: 10.1159/000200976.
We studied if the fecal fat concentration as measured by the near infrared reflectance analysis in a spot sample is an acceptable screening test for malabsorption. This measurement was compared with the more complex fat balance in 120 patients with a suspected malabsorption [53 with chronic pancreatic disorders (CP), 67 with other digestive disorders (nCP)]. The fecal fat concentration proved to be well correlated with steatorrhea in CP (r = 0.86) but not in nCP (r = 0.35). A fat concentration of 9 g% had a sensitivity and a specificity for steatorrhea of 88.8% and of 97.1% in CP, but only of 53.8% and of 94.4% respectively in nCP. The fecal fat concentration was significantly higher in CP than in nCP, even considering patients with steatorrhea only; however, the overlap between the two groups was too high to suggest a clinical usefulness of this test in the differential diagnosis of steatorrheas. It is concluded that the fat concentration in a small sample, easily obtained also in outpatients, is useful in the selection of patients with chronic pancreatitis to submit to a proper fat balance study.
我们研究了通过点样的近红外反射率分析测定的粪便脂肪浓度是否是一种可接受的吸收不良筛查试验。将该测量结果与120例疑似吸收不良患者（53例患有慢性胰腺疾病（CP），67例患有其他消化系统疾病（非CP））中更复杂的脂肪平衡情况进行了比较。结果表明，粪便脂肪浓度在CP患者中与脂肪泻有良好的相关性（r = 0.86），而在非CP患者中则无相关性（r = 0.35）。脂肪浓度为9 g%时，在CP患者中对脂肪泻的敏感性和特异性分别为88.8%和97.1%，而在非CP患者中分别仅为53.8%和94.4%。即使仅考虑有脂肪泻的患者，CP患者的粪便脂肪浓度也显著高于非CP患者；然而，两组之间的重叠过高，无法表明该试验在脂肪泻鉴别诊断中的临床实用性。结论是，在门诊患者中也容易获得的小样本中的脂肪浓度，对于选择慢性胰腺炎患者进行适当的脂肪平衡研究是有用的。
