Nakamura T, Tandoh Y, Terada A, Yamada N, Watanabe T, Kaji A, Imamura K, Kikuchi H, Suda T
3rd Department of Internal Medicine, Hirosaki University School of Medicine, Aomori, Japan.
Int J Pancreatol. 1998 Feb;23(1):63-70. doi: 10.1007/BF02787504.
Steatorrhea was almost completely stopped and malabsorption of neutral sterols and short-chain fatty acids was reduced by treatment of high-lipase pancreatin in Japanese patients with pancreatic insufficiency whose dietary fat consumption is low.
Fifteen patients with chronic pancreatitis complicated by steatorrhea who consumed an average of 48 g of dietary fats a day were selected as subjects and given 3 g of high-lipase pancreatin (lipase, 379,800 USP U/g), at each meal (total daily dose is 9 g) for a mean duration of 28.5 d. Fecal output and fecal fat neutral sterol, bile acid, and short-chain fatty acid excretion were determined before and after the course of pancreatin therapy.
Pancreatin administration resulted in significant reductions (P < 0.01) in fecal output (from 243.2 to 149.1 g), excretion of fecal fat, (from 12.3 to 3.9 g), animal sterols (from 816.3 to 604.6 mg), and short-chain fatty acids (from 52.6 to 18.5 mM). In contrast, no marked changes were recorded in fecal excretion of beta-sitosterol (a plant sterol), bile acids, or the hydroxy fatty acid fraction. Fecal fat and short-chain fatty-acid excretion showed strong correlations with fecal output.
对于脂肪摄入量低的日本胰腺功能不全患者，高活性胰酶治疗可几乎完全消除脂肪泻，并减少中性固醇和短链脂肪酸的吸收不良。
选取15例慢性胰腺炎合并脂肪泻且每日平均摄入48g膳食脂肪的患者作为研究对象，每餐给予3g高活性胰酶（脂肪酶，379,800美国药典单位/g）（每日总剂量为9g），平均治疗28.5天。在胰酶治疗前后分别测定粪便量以及粪便中脂肪、中性固醇、胆汁酸和短链脂肪酸的排泄量。
服用胰酶后，粪便量（从243.2g降至149.1g）、粪便脂肪排泄量（从12.3g降至3.9g）、动物固醇排泄量（从816.3mg降至604.6mg）和短链脂肪酸排泄量（从52.6mM降至18.5mM）均显著减少（P<0.01）。相比之下，β-谷固醇（一种植物固醇）、胆汁酸或羟基脂肪酸组分的粪便排泄量无明显变化。粪便脂肪和短链脂肪酸排泄量与粪便量密切相关。
