Warshaw A L, Bellini C A, Lesser P B
Ann Surg. 1975 Jul;182(1):72-5. doi: 10.1097/00000658-197507000-00014.
In 6 of 7 patients with acute pancreatitis and hyperlipemia, inhibition of serum amylase activity was detected by dilution of the serum before assaying for amylase and by correcting for tthe dilution factor. In 4 patients the inhibition phenomenon disappeared within the first few days of hospitalization as the elevated serum triglycerides fell. However, in 2 others there was no relation between triglyceride level and amylase inhibition. Removal of the excess serum lipids by ultracentrifugation did not eliminate the inhibition of amylase activity. Inhibition of amylase activity also occurred in the urine of these patients. No amylase inhibition was demonstrable in lipemic serum from patients without pancreatitis or in pancreatitis serum to which excess lipids were added. The data suggest the presence of a circulating inhibitor of amylase, distinct from the elevated serum lipids, in the serum and urine of patients with acute pancreatitis associated with hyperlipemia. The diagnosis of acute pancreatitis in the patient with abdominal pain and lactescent serum can be facilitated by correcting the serum amylase activity by dilution.
在7例急性胰腺炎合并高脂血症患者中，有6例在测定淀粉酶前通过稀释血清并校正稀释因子检测到血清淀粉酶活性受到抑制。4例患者在住院的头几天内，随着血清甘油三酯水平的下降，抑制现象消失。然而，另外2例患者的甘油三酯水平与淀粉酶抑制之间没有关联。通过超速离心去除过量的血清脂质并不能消除淀粉酶活性的抑制。这些患者的尿液中也出现了淀粉酶活性抑制。在无胰腺炎患者的脂血血清中或添加了过量脂质的胰腺炎血清中未发现淀粉酶抑制现象。数据表明，在急性胰腺炎合并高脂血症患者的血清和尿液中存在一种与升高的血清脂质不同的循环淀粉酶抑制剂。对于有腹痛和乳糜样血清的患者，通过稀释校正血清淀粉酶活性有助于急性胰腺炎的诊断。
