Alkaade Samer, Vareedayah Ashley A
Saint Louis University, 3635 Vista Ave at Grand Blvd, St Louis, MO 63110. E-mail:
Am J Manag Care. 2017 Jul;23(12 Suppl):S203-S209.
Exocrine pancreatic insufficiency (EPI) is characterized by a deficiency of exocrine pancreatic enzymes, resulting in deficits in digestion of all macronutrients, with deficiencies in digestion of fats being the most clinically relevant. The leading cause of EPI is chronic pancreatitis. However, many other causes and conditions may be implicated, including cystic fibrosis, pancreatic duct obstruction, gastric and pancreatic surgery, diabetes mellitus and other conditions. Physical and biochemical causes of EPI include decreased production and secretion of lipase, increased lipase destruction, pancreatic duct obstruction, decreased lipase stimulation and degradation, as well as gastrointestinal motility disorders. EPI is largely diagnosed clinically, and is often identified by symptoms such as steatorrhea, weight loss, abdominal discomfort, and abdominal bloating. Lifestyle modifications (eg, smoking cessation, limiting or avoiding alcoholic drinks, and reducing dietary fat intake) and exogenous pancreatic enzyme supplements are commonly used to help restore normal digestion and absorption of dietary nutrients in patients with EPI.
外分泌性胰腺功能不全（EPI）的特征是外分泌性胰腺酶缺乏，导致所有宏量营养素消化不足，其中脂肪消化不足在临床上最为相关。EPI的主要原因是慢性胰腺炎。然而，许多其他原因和病症也可能与之相关，包括囊性纤维化、胰管阻塞、胃和胰腺手术、糖尿病及其他病症。EPI的生理和生化原因包括脂肪酶产生和分泌减少、脂肪酶破坏增加、胰管阻塞、脂肪酶刺激和降解减少以及胃肠动力障碍。EPI主要通过临床诊断，通常由脂肪泻、体重减轻、腹部不适和腹胀等症状来识别。生活方式的改变（如戒烟、限制或避免饮酒以及减少饮食脂肪摄入）和外源性胰腺酶补充剂通常用于帮助EPI患者恢复饮食营养的正常消化和吸收。
