Dutta S K, Anand K, Gadacz T R
Gastroenterology. 1986 Nov;91(5):1243-9. doi: 10.1016/s0016-5085(86)80023-3.
Twenty patients with exocrine pancreatic insufficiency secondary to alcohol abuse were studied for the presence of bile salt malabsorption. Fecal bile salts and fecal fat excretion were determined in 15 patients receiving pancreatic enzyme therapy, not receiving enzyme therapy, and on a regimen of pancreatic enzymes plus cimetidine. Serum bile salt levels were measured during fasting and postprandial conditions both during enzyme therapy and after it was stopped in 8 cases. In addition, 5 patients underwent [14C]cholylglycine breath testing during and after discontinuation of enzyme therapy. The fecal bile salt excretion varied between 610 and 3460 mg/day in the untreated patients. Treatment with pancreatic enzymes was associated with significant (p less than 0.05) reduction in fecal bile salt and fecal fat excretion. Cimetidine therapy in addition to enzyme therapy further reduced steatorrhea but failed to alter bile salt excretion significantly. Serum cholylglycine level showed significant (p less than 0.05) postprandial increase in patients receiving enzyme therapy, suggesting improved bile salt absorption. These data suggest a wide range of bile salt malabsorption in alcoholic patients with pancreatic insufficiency, which improves with pancreatic enzyme therapy.
对20例因酒精滥用继发外分泌性胰腺功能不全的患者进行了胆盐吸收不良情况的研究。测定了15例接受胰酶治疗、未接受酶治疗以及采用胰酶加西咪替丁治疗方案的患者的粪便胆盐和粪便脂肪排泄量。在8例患者的酶治疗期间及停止治疗后，分别测定了空腹和餐后状态下的血清胆盐水平。此外，5例患者在酶治疗期间及停药后接受了[14C]胆酰甘氨酸呼气试验。未经治疗的患者粪便胆盐排泄量在610至3460毫克/天之间。胰酶治疗可使粪便胆盐和粪便脂肪排泄量显著减少（p<0.05）。酶治疗加用西咪替丁进一步减轻了脂肪泻，但未显著改变胆盐排泄。接受酶治疗的患者血清胆酰甘氨酸水平餐后显著升高（p<0.05），提示胆盐吸收改善。这些数据表明，酒精性胰腺功能不全患者存在广泛的胆盐吸收不良，胰酶治疗可改善这种情况。
