Stanescu A, Mayer D, Rosenthal J, Malfertheiner P
Abteilung Innere Medizin II und Gastroenterologie, Universität Ulm.
Leber Magen Darm. 1990 Mar;2(2):83-9.
Amylase concentration in serum is frequently found increased in chronic renal insufficiency without being associated with pancreatic diseases. A prospective study was performed in 71 patients with chronic renal insufficiency undergoing hemodialysis for comparison of different pancreatic enzymes in serum. 7 patients were not considered in this comparative study because of chronic pancreatitis-like-changes in ultrasound. Increased serum concentrations were found for total amylase in 27 patients (42.2%), pancreatic amylase in 26 patients (25.0%), lipase in 50 patients (78.1%), immunoreactive trypsin in 61 patients (95.3%) and for elastase 1 in 7 patients (10.9%). Hemodialysis did not affect any of the investigated pancreatic serum-enzymes. Elastase 1 determination in serum appears superior to the other pancreatic serum-enzymes because of higher specificity, not limited by renal insufficiency. The different serum concentration of elastase 1 and trypsin, which have a similar molecular weight, points towards a completely different clearance mechanism for these enzymes.
慢性肾功能不全患者血清淀粉酶浓度常升高，且与胰腺疾病无关。对71例接受血液透析的慢性肾功能不全患者进行了一项前瞻性研究，以比较血清中不同胰腺酶的情况。由于超声检查发现7例患者有类似慢性胰腺炎的改变，故未纳入此项对比研究。27例患者（42.2%）血清总淀粉酶浓度升高，26例患者（25.0%）胰腺淀粉酶升高，50例患者（78.1%）脂肪酶升高，61例患者（95.3%）免疫反应性胰蛋白酶升高，7例患者（10.9%）弹性蛋白酶1升高。血液透析对所检测的任何胰腺血清酶均无影响。血清弹性蛋白酶1检测似乎优于其他胰腺血清酶，因为其特异性更高，不受肾功能不全的限制。分子量相似的弹性蛋白酶1和胰蛋白酶血清浓度不同，表明这两种酶的清除机制完全不同。
