慢性胰腺炎患者粪弹力蛋白酶检测的临床价值

CLINICAL APPLICATION OF FECAL ELASTASE TEST IN PATIENTS WITH CHRONIC PANCREATITIS

为探讨粪弹力蛋白酶 (E1)试验对慢性胰腺炎患者胰腺外分泌功能检测的临床应用价值 ,应用酶联免疫吸附试验 (ELISA)方法对 5 5例慢性胰腺炎、2 5例非胰腺消化系疾病患者进行了E1的检测 ,并同时与尿BT PABA检测结果进行对比。慢性胰腺炎患者粪E1及尿BT PABA排除率均明显低于非胰腺疾病组 (P <0 0 5 )。以 2 0 0 μg/ g为界 ,对慢性胰腺炎患者粪E1的敏感性轻度者为 14 3% ,中度者为 36 8% ,重度者为 86 7% ,总的敏感性为 5 1% ,特异性为 86 %。提示慢性胰腺炎患者存在E1的下降 ,但对诊断轻至中度慢性胰腺炎者其敏感性较差 ,而对重度胰腺炎患者其敏感性、特异性均较高 ,对临床诊断、治疗有指导意义。

The aim of this study was to evaluate the clinical application of fecal elastase test in exocrine insufficiency of chronic pancreatitic patieats. The fecal elastase 1 was detected by ELISA method in 55 cases with chronic pancreatitis(CP) and 25 cases with nonpancreatic digestive disease, and the urine BT PABA was measured by DACA method simultaniously.The results showed that the fecal elastase 1 and urine BT PABA excretion in patients with CP were much lower than those in patients with nonpancreatic disease ( P <0 05). With a cut off of 200μg/g the sensitivity of stool elastase 1 was 14 3% in mild CP, 36 8% in moderate CP, and 86 7% in severe CP. In all, the total sensitivity was 51% and the specificity was 86%. So the data of the present study show good sensitivity and specificity of fecal elastase 1 determination in severe CP but limited sensitivity in mild CP and moderate CP. All in all the fecal elastase test is proved to be a helpful method in clinic diagnosis and treatment of CP.