Griffin S M, Alderson D, Farndon J R
Department of Surgery, Medical School, University of Newcastle upon Tyne.
Gut. 1989 Jul;30(7):1012-5. doi: 10.1136/gut.30.7.1012.
Conventional treatment of pancreatic steatorrhoea in man has been unsatisfactory because 90% of the lipase content of therapy is inactivated by acid in the stomach and large doses of replacement treatment are needed to provide adequate supplementation. An acid stable agent (fungal lipase) was investigated in the treatment of pancreatic deficiency steatorrhoea in 11 pancreatectomised dogs maintained on a fixed dietary intake of fat and treated with pancreatin or fungal lipase. Ten grams (60,000 U lipase) of pancreatin was compared with 400mg (4800 U lipase) of fungal lipase administered with each meal against a no treatment group. There was no significant difference in stool bulk and faecal fat excretion between pancreatin and lipase treated animals. Both groups showed a significant reduction in stool bulk and fat excretion when compared with the no treatment group (p less than 0.01). A markedly diminished treatment volume, in the form of fungal lipase, is as effective in controlling steatorrhoea as pancreatin and may prove to be a potentially valuable therapy for patients with pancreatic insufficiency.
人类胰腺性脂肪泻的传统治疗方法并不令人满意，因为治疗中90%的脂肪酶会被胃酸灭活，需要大剂量的替代治疗来提供足够的补充。研究了一种耐酸制剂（真菌脂肪酶）对11只胰腺切除犬胰腺功能不全性脂肪泻的治疗效果，这些犬维持固定的脂肪饮食摄入量，并接受胰酶或真菌脂肪酶治疗。每餐将10克（60,000单位脂肪酶）的胰酶与400毫克（4800单位脂肪酶）的真菌脂肪酶进行比较，设不治疗组作为对照。胰酶治疗组和真菌脂肪酶治疗组动物的粪便量和粪便脂肪排泄量无显著差异。与不治疗组相比，两组的粪便量和脂肪排泄量均显著减少（p<0.01）。以真菌脂肪酶形式显著减少的治疗剂量在控制脂肪泻方面与胰酶一样有效，可能被证明是治疗胰腺功能不全患者的一种潜在有价值的疗法。
