Kitagawa M, Hayakawa T, Kondo T, Shibata T, Sakai Y, Sobajima H, Ishiguro H, Nakae Y
Second Department of Internal Medicine, Nagoya University School of Medicine, Japan.
Gastroenterol Jpn. 1991 Feb;26(1):62-8. doi: 10.1007/BF02779511.
The diagnostic significance of serum immunoreactive pancreatic phospholipase A2 (PLA2) was studied in 119 patients with pancreatic disease, 200 with various non-pancreatic disease, and 203 healthy controls using radioimmunoassay (RIA) specific to human pancreatic PLA2. This newly developed RIA using monoclonal antibody was satisfactorily sensitive and reliable. Serum PLA2 was elevated in all six patients with acute pancreatitis. Frequency of abnormal serum PLA2 levels was 60% in chronic pancreatitis (n = 52) and 67% in pancreatic cancer (n = 61). Serum PLA2 levels were low in chronic pancreatitis with severe exocrine insufficiency and advanced pancreatic cancer. In chronic pancreatitis, patients with low serum PLA2 level showed lower enzyme output in secretin test than patients with normal or high serum PLA2 level. Frequency of abnormal PLA2 levels was 27% in non-pancreatic disease and, in particular, patients with renal failure showed high PLA2 levels. Sensitivity (62%) and efficiency (69%) of serum PLA2 assay in pancreatic disease were superior to those of amylase. In conclusion, serum PLA2 determination using RIA was useful for the diagnosis of acute pancreatitis by high serum PLA2 levels and the diagnosis of severe exocrine pancreatic insufficiency by low serum PLA2 levels.
采用针对人胰腺磷脂酶A2（PLA2）的放射免疫分析法（RIA），对119例胰腺疾病患者、200例各种非胰腺疾病患者及203名健康对照者进行血清免疫反应性胰腺PLA2诊断意义的研究。这种新开发的使用单克隆抗体的RIA具有令人满意的敏感性和可靠性。所有6例急性胰腺炎患者的血清PLA2均升高。慢性胰腺炎（n = 52）患者血清PLA2水平异常的频率为60%，胰腺癌（n = 61）患者为67%。慢性胰腺炎伴严重外分泌功能不全及晚期胰腺癌患者的血清PLA2水平较低。在慢性胰腺炎中，血清PLA2水平低的患者在胰泌素试验中的酶分泌量低于血清PLA2水平正常或高的患者。非胰腺疾病患者PLA2水平异常的频率为27%，尤其是肾衰竭患者的PLA2水平较高。血清PLA2检测在胰腺疾病诊断中的敏感性（62%）和有效性（69%）优于淀粉酶。总之，使用RIA测定血清PLA2有助于通过血清PLA2水平升高诊断急性胰腺炎，以及通过血清PLA2水平降低诊断严重胰腺外分泌功能不全。
