Mathew Alok, Fernandes Darren, Andreyev H Jervoise N
Royal Derby Hospital, Derby, UK.
Department of Gastroenterology, United Lincolnshire Hospitals NHS Trust, Lincoln, UK.
Frontline Gastroenterol. 2023 Feb 9;14(5):371-376. doi: 10.1136/flgastro-2022-102271. eCollection 2023.
Pancreatic exocrine insufficiency is a cause of malabsorption. It is generally diagnosed if faecal elastase-1 (FE-1) levels are below 200 µg/g. Pancreatic function is assumed to be normal when faecal elastase levels are >500 µg/g. The significance of faecal elastase levels above 200 µg/g but less than 500 µg/g is unclear.
This retrospective study reports the response to treatment in patients who had an FE-1 level between 200 and 500 µg/g.
Of these 82 patients, 28 were offered pancreatic enzyme replacement therapy (PERT). A clinical response, defined as an improvement in their initial symptoms after commencing PERT, was seen in 20 patients (71%), 7 with potentially predisposing conditions and 13 with functional diarrhoea. PERT particularly abolished or improved diarrhoea, steatorrhoea and flatulence.
Clinicians should, therefore, be aware that a trial of PERT given to patients with FE-1 levels between 200 and 500 µg/g may lead to improvement in gastrointestinal symptoms.
胰腺外分泌功能不全是吸收不良的一个原因。如果粪便弹性蛋白酶-1（FE-1）水平低于200µg/g，通常可诊断为此病。当粪便弹性蛋白酶水平>500µg/g时，胰腺功能被认为正常。粪便弹性蛋白酶水平高于200µg/g但低于500µg/g的意义尚不清楚。
这项回顾性研究报告了FE-1水平在200至500µg/g之间的患者的治疗反应。
在这82例患者中，28例接受了胰酶替代疗法（PERT）。20例患者（71%）出现临床反应，即开始PERT治疗后初始症状有所改善，其中7例有潜在易感疾病，13例有功能性腹泻。PERT尤其消除或改善了腹泻、脂肪泻和肠胃胀气。
因此，临床医生应意识到，对FE-1水平在200至500µg/g之间的患者进行PERT试验可能会改善胃肠道症状。
