Girish Banavara Narasimhamurthy, Rajesh Gopalakrishna, Vaidyanathan Kannan, Balakrishnan Vallath
Department of Physiology, Amrita Institute of Medical Sciences, Amrita Lane, Ponekkara PO, Cochin, 682 041, Kerala, India.
Indian J Gastroenterol. 2009 Dec;28(6):201-5. doi: 10.1007/s12664-009-0079-z. Epub 2010 Feb 23.
Measurement of pancreatic exocrine function and steatorrhea in chronic pancreatitis in the clinical setting has not received much attention.
To assess pancreatic exocrine function and fecal fat excretion in a cohort of patients with chronic pancreatitis.
Stool elastase1 levels were measured in 101 patients using polyclonal ELISA and acid steatocrit was measured in 86 chronic pancreatitis patients. Associations with etiology, clinical and radiological features, and diabetic status were examined.
Low pancreatic stool elastase1 (<200 microg/g stool) was observed in two-thirds of chronic pancreatitis patients and correlated with ductal dilatation, pancreatic atrophy and calcification (p<0.05). Diabetes was more prevalent in chronic pancreatitis patients with low elastase1 (p=0.045). There was no difference in mean acid steatocrit between diabetics and non-diabetics (p=0.069). Elastase1 levels had a negative correlation with acid steatocrit (r=-0.606, p<0.001), and a positive correlation (r=0.412) with body mass index (p=0.013). Fifty-three percent of chronic pancreatitis patients with normal BMI had low elastase1.
Fecal elastase1 levels correlated with fecal fat excretion and BMI. Fecal elastase1 estimation may be helpful in early detection of malabsorption in chronic pancreatitis.
在临床环境中，慢性胰腺炎患者胰腺外分泌功能和脂肪泻的测量并未受到太多关注。
评估一组慢性胰腺炎患者的胰腺外分泌功能和粪便脂肪排泄情况。
采用多克隆ELISA法测定101例患者的粪便弹性蛋白酶1水平，86例慢性胰腺炎患者测定酸脂肪细胞比。研究其与病因、临床和放射学特征以及糖尿病状态的相关性。
三分之二的慢性胰腺炎患者粪便弹性蛋白酶1水平较低（<200微克/克粪便），且与导管扩张、胰腺萎缩和钙化相关（p<0.05）。弹性蛋白酶1水平低的慢性胰腺炎患者糖尿病更为常见（p=0.045）。糖尿病患者和非糖尿病患者的平均酸脂肪细胞比无差异（p=0.069）。弹性蛋白酶1水平与酸脂肪细胞比呈负相关（r=-0.606，p<0.001），与体重指数呈正相关（r=0.412）（p=0.013）。体重指数正常的慢性胰腺炎患者中有53%弹性蛋白酶1水平较低。
粪便弹性蛋白酶1水平与粪便脂肪排泄和体重指数相关。粪便弹性蛋白酶1测定可能有助于早期发现慢性胰腺炎中的吸收不良。
