Hart Phil A, Conwell Darwin L
Section of Pancreatic Disorders, Division of Gastroenterology, Hepatology, & Nutrition, The Ohio State University Wexner Medical Center, 410 West Tenth Avenue, Columbus, OH, 43210, USA,
Curr Treat Options Gastroenterol. 2015 Sep;13(3):347-53. doi: 10.1007/s11938-015-0057-8.
The accurate diagnosis of exocrine pancreatic insufficiency (EPI) helps identify those in need of pancreatic enzyme replacement therapy. Conversely, ruling out EPI identifies those in which additional evaluation should be pursued to explain their symptoms. There are many available tests that can be used to diagnose EPI; however, the tests must be tailored to each clinical scenario. Tests that are convenient but less accurate (e.g., fecal elastase-1, qualitative fecal fat determination) are best suited for patients with a high pretest probability of EPI. In contrast, tests that are highly accurate but more cumbersome (e.g., endoscopic pancreatic function testing, 72-h fecal fat collection) are favored in patients suspected to have mild EPI or an early stage of chronic pancreatitis. Additional research is needed to identify a more convenient means of accurately diagnosing at all stages of EPI.
外分泌性胰腺功能不全（EPI）的准确诊断有助于确定那些需要进行胰腺酶替代治疗的患者。相反，排除EPI则可确定那些需要进一步评估以解释其症状的患者。有许多可用的检查可用于诊断EPI；然而，这些检查必须根据每个临床情况进行调整。方便但准确性较低的检查（如粪便弹性蛋白酶-1、定性粪便脂肪测定）最适合EPI预测概率较高的患者。相比之下，高度准确但更为繁琐的检查（如内镜胰腺功能测试、72小时粪便脂肪收集）则更适用于疑似轻度EPI或慢性胰腺炎早期的患者。需要进一步研究以确定一种更方便的方法来准确诊断EPI的各个阶段。
