Capurso Gabriele, Traini Mariaemilia, Piciucchi Matteo, Signoretti Marianna, Arcidiacono Paolo Giorgio
Pancreato-Biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Centre, San Raffaele Scientific Institute, Vita Salute San Raffaele University, Milan, Italy,
Digestive and Liver Disease Unit, Sant'Andrea Hospital, Sapienza University, Rome, Italy.
Clin Exp Gastroenterol. 2019 Mar 21;12:129-139. doi: 10.2147/CEG.S168266. eCollection 2019.
Exocrine pancreatic insufficiency (EPI) is a condition caused by reduced or inappropriate secretion or activity of pancreatic juice and its digestive enzymes, pancreatic lipase in particular. EPI can result in clinical manifestation and biochemical alterations causing reduced quality of life and life-threating complications. EPI is common in pancreatic disorders, where it should be suspected and actively investigated, and in many extrapancreatic conditions. There are various tests available to diagnose EPI, with indirect, noninvasive ones, such as concentration of fecal elastase being more commonly employed. Administration of pancreatic enzymes replacement therapy remains the mainstay of EPI treatment. The present review article will discuss current evidence regarding the prevalence of EPI, the available tests to diagnose it and its treatment.
外分泌性胰腺功能不全(EPI)是一种由胰液及其消化酶,尤其是胰脂肪酶分泌减少或分泌不当或活性降低所引起的病症。EPI可导致临床表现和生化改变,进而降低生活质量并引发危及生命的并发症。EPI在胰腺疾病中很常见,对此应予以怀疑并积极进行检查,在许多胰腺外疾病中也较为常见。有多种检查可用于诊断EPI,其中间接的非侵入性检查,如粪便弹性蛋白酶浓度检查,使用更为普遍。给予胰酶替代疗法仍然是EPI治疗的主要手段。本综述文章将讨论有关EPI患病率、现有诊断检查及其治疗的当前证据。