Brattström C, Tollemar J, Ringdén O, Bergström K, Tydén G
Department of Transplantation Surgery, Karolinska Institute, Huddinge Hospital, Sweden.
Transpl Int. 1991 Jun;4(2):96-8. doi: 10.1007/BF00336405.
The mean total serum amylase levels in patients was 3.2 +/- 0.5 mukat/l (+/-SE) before total body irradiation (TBI) prior to bone marrow transplantation of which 50% was due to pancreatic isoamylase and 50% salivary isoamylase. Total serum amylase increased to a maximum of 100.3 +/- 12.3 mukat/l on the first day after TBI and most of this increase was due to an increase in salivary isoamylase (90.0 +/- 12.1 mukat/l). In association with this, all patients had clinical symptoms of parotitis. An increase in pancreatic isoamylase was found in 27% of the patients; however, none of them had clinical symptoms of pancreatitis. Serum amylase levels returned to normal within 5 days after TBI but then decreased to subnormal values, remaining below the normal range for 3 weeks. Pancreatic isoamylase returned to pre-irradiation levels 1.5 months after TBI, while salivary isoamylase remained low for the rest of the observation time. TBI of 7.5 Gy at 26 cGy/min gave significantly lower salivary amylase at 2 days after TBI compared with 10 Gy at 4 cGy/min: 32 +/- 4 versus 76 +/- 13 mukat/l (P less than 0.05). At 2.5 and 6 months after TBI significantly higher total amylase levels were recorded for patients treated with 7.5 Gy of TBI compared with 10 Gy: 2.5 +/- 0.4 and 2.7 +/- 0.3 versus 2.0 +/- 0.5 and 0.8 +/- 0.3 mukat/l, respectively (P less than 0.01, P less than 0.05, respectively). Acute or chronic GVHD did not affect acinar cells in this investigation.
患者血清总淀粉酶水平在骨髓移植前全身照射（TBI）前平均为3.2±0.5缪卡/升（±标准误），其中50% 来自胰腺同工淀粉酶，50% 来自唾液同工淀粉酶。TBI后第一天血清总淀粉酶最高升至100.3±12.3缪卡/升，且这种升高大多归因于唾液同工淀粉酶升高（90.0±12.1缪卡/升）。与此同时，所有患者均出现腮腺炎临床症状。27% 的患者发现胰腺同工淀粉酶升高；然而，他们均无胰腺炎临床症状。TBI后5天内血清淀粉酶水平恢复正常，但随后降至低于正常范围，持续3周。胰腺同工淀粉酶在TBI后1.5个月恢复至照射前水平，而唾液同工淀粉酶在剩余观察期内一直保持较低水平。与以4厘戈瑞/分钟照射10戈瑞相比，以26厘戈瑞/分钟照射7.5戈瑞的TBI在TBI后2天唾液淀粉酶显著降低：分别为32±4与76±13缪卡/升（P<0.05）。TBI后2.5个月和6个月，接受7.5戈瑞TBI治疗的患者总淀粉酶水平显著高于接受10戈瑞治疗的患者：分别为2.5±0.4和2.7±0.3与2.0±0.5和0.8±0.3缪卡/升（分别为P<0.01，P<0.05）。在本研究中，急性或慢性移植物抗宿主病（GVHD）未影响腺泡细胞。
