Diagnosis of Exocrine Pancreatic Insufficiency.
Diagnosis of Exocrine Pancreatic Insufficiency.
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DOI：
10.1007/s11938-015-0057-8
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发表时间：
2015-09-01
期刊：
影响因子：
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通讯作者：
Conwell, Darwin L
中科院分区：
文献类型：
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作者：
Hart, Phil A;Conwell, Darwin L
意见声明：胰腺外分泌功能不全（EPI）的准确诊断有助于确定需要胰酶替代治疗的患者。相反，排除EPI可以识别那些应该进行额外评估以解释其症状的患者。有许多可用的测试，可用于诊断EPI;然而，测试必须针对每个临床情况。方便但不太准确的测试（例如，粪便弹性蛋白酶-1，定性粪便脂肪测定）最适合于具有高EPI预试验概率的患者。相比之下，高度准确但更麻烦的测试（例如，内镜胰腺功能检查，72小时粪便脂肪收集）在怀疑患有轻度EPI或早期慢性胰腺炎的患者中是有利的。需要进一步的研究来确定一种更方便的方法，在EPI的各个阶段进行准确的诊断。
OPINION STATEMENT: The accurate diagnosis of exocrine pancreatic insufficiency (EPI) helps identify those in need of pancreatic enzyme replacement therapy. Conversely, ruling out EPI identifies those in which additional evaluation should be pursued to explain their symptoms. There are many available tests that can be used to diagnose EPI; however, the tests must be tailored to each clinical scenario. Tests that are convenient but less accurate (e.g., fecal elastase-1, qualitative fecal fat determination) are best suited for patients with a high pretest probability of EPI. In contrast, tests that are highly accurate but more cumbersome (e.g., endoscopic pancreatic function testing, 72-h fecal fat collection) are favored in patients suspected to have mild EPI or an early stage of chronic pancreatitis. Additional research is needed to identify a more convenient means of accurately diagnosing at all stages of EPI.