Sugimoto Y, Hayakawa T, Kondo T, Shibata T, Kishimoto W
Second Department of Internal Medicine, Nagoya University School of Medicine, Japan.
J Gastroenterol Hepatol. 1990 Sep-Oct;5(5):493-8. doi: 10.1111/j.1440-1746.1990.tb01429.x.
To clarify the contribution of peritoneal absorption of enzyme-rich exudate to the persistent elevation of serum amylase in bile-induced pancreatitis in dogs, serum amylase, lipase and immunoreactive trypsin (IRT) levels were measured during 24 h after induction of pancreatitis with and without peritoneal lavage. The basal level of serum amylase activity (m +/- s.e. = 1291 +/- 111 U/L) reached a plateau at 30 min (2688 +/- 185) after induction of pancreatitis and continued to rise until 24 h (7201 +/- 424). This persistent amylase elevation could be reduced significantly by peritoneal lavage. Serum IRT rose to a peak (378 +/- 103 ng/mL) at 30 min from the basal (20 +/- 5), then decreased until 3 h (211 +/- 34) and maintained a consistent level thereafter. Serum lipase elevation took an intermediate course between the levels of serum amylase and IRT. Intraperitoneal injection of 5 mL pancreatic juice could reproduce similar elevations to those of the respective enzymes, except lipase, seen in pancreatitis. These results suggest that transperitoneal absorption of pancreatic enzymes contributes to the elevation in serum enzymes levels and that rates of peritoneal absorption and serum disappearance differ from enzyme to enzyme.
为阐明富含酶的渗出液经腹膜吸收对犬胆汁性胰腺炎血清淀粉酶持续升高的作用，在诱导胰腺炎后24小时内，对有或无腹膜灌洗的犬测量血清淀粉酶、脂肪酶和免疫反应性胰蛋白酶（IRT）水平。血清淀粉酶活性的基础水平（m±标准误=1291±111 U/L）在诱导胰腺炎后30分钟（2688±185）达到平台期，并持续上升直至24小时（7201±424）。这种淀粉酶的持续升高可通过腹膜灌洗显著降低。血清IRT在30分钟时从基础水平（20±5）升至峰值（378±103 ng/mL），然后下降直至3小时（211±34），此后维持在一个稳定水平。血清脂肪酶的升高过程介于血清淀粉酶和IRT之间。腹腔注射5 mL胰液可重现胰腺炎中除脂肪酶外各酶类似的升高情况。这些结果表明，胰腺酶经腹膜吸收导致血清酶水平升高，且不同酶的腹膜吸收率和血清清除率各不相同。
