Pezzilli R, Gullo L, Ricchi E, Costigliola P, Sprovieri G, Pilati G, Fontana G
Emergency Department, St. Orsola Hospital, Bologna, Italy.
Dig Dis Sci. 1992 Feb;37(2):286-8. doi: 10.1007/BF01308185.
Serum concentrations of trypsin and elastase I were determined in 109 HIV Ab-positive patients (52 asymptomatic HIV-infected patients, 25 with lymphadenopathy syndrome, and 32 with acquired immunodeficiency syndrome) to assess the prevalence of possible pancreatic damage in these patients. Serum trypsin was abnormally elevated in 46 of the 109 patients (42.2%): 19 of the 52 asymptomatic HIV-infected patients (36.6%), 9 of the 25 with lymphadenopathy syndrome (36%), and 18 of the 32 with acquired immunodeficiency syndrome (56.3%). Serum elastase 1 was elevated in 14 of the 109 HIV Ab-positive patients (12.8%): 3 of the 52 asymptomatic HIV-infected patients (5.8%), 3 of the 25 with lymphadenopathy syndrome (12%), and 8 of the 32 with acquired immunodeficiency syndrome (25%). None of the patients with abnormally high serum pancreatic enzyme concentrations had clinically evident pancreatic disease. There was no statistically significant difference in serum levels of trypsin and elastase I between drug addicts and nonaddicts, between alcoholics and nonalcoholics, or between those with cytomegalovirus infection and those without. A significant inverse relationship was found between serum enzyme concentrations and the number of CD4+ lymphocytes. The results of this study show that high levels of serum trypsin and elastase are present in an elevated percentage of patients with acquired immunodeficiency syndrome, suggesting that the pancreas is frequently damaged in this disease. The finding of abnormally high serum enzyme concentrations not only in patients with AIDS, but also in asymptomatic carriers and in patients with lymphadenopathy syndrome suggests an association between HIV infection and the development of pancreatic lesions.
测定了109例HIV抗体阳性患者（52例无症状HIV感染者、25例患有淋巴结病综合征患者和32例获得性免疫缺陷综合征患者）的血清胰蛋白酶和弹性蛋白酶I浓度，以评估这些患者中可能存在的胰腺损伤患病率。109例患者中有46例（42.2%）血清胰蛋白酶异常升高：52例无症状HIV感染者中有19例（36.6%），25例患有淋巴结病综合征患者中有9例（36%），32例获得性免疫缺陷综合征患者中有18例（56.3%）。109例HIV抗体阳性患者中有14例（12.8%）血清弹性蛋白酶1升高：52例无症状HIV感染者中有3例（5.8%），25例患有淋巴结病综合征患者中有3例（12%），32例获得性免疫缺陷综合征患者中有8例（25%）。血清胰腺酶浓度异常升高的患者均无临床明显的胰腺疾病。吸毒者与非吸毒者、酗酒者与非酗酒者或巨细胞病毒感染患者与未感染患者之间，血清胰蛋白酶和弹性蛋白酶I水平无统计学显著差异。血清酶浓度与CD4+淋巴细胞数量之间存在显著的负相关关系。本研究结果表明，获得性免疫缺陷综合征患者中血清胰蛋白酶和弹性蛋白酶水平升高的比例较高，提示该疾病中胰腺经常受损。不仅在艾滋病患者中，而且在无症状携带者和患有淋巴结病综合征的患者中发现血清酶浓度异常升高，提示HIV感染与胰腺病变的发生之间存在关联。
