Ventrucci M, Pezzilli R, Gullo L
Institute of Medicine and Gastroenterology, University of Bologna, St. Orsola Hospital, Italy.
Am J Gastroenterol. 1990 Oct;85(10):1381-5.
A method has recently been developed for measuring serum pancreatic (P) isoamylase, using two monoclonal antibodies specific for salivary isoamylase. We performed this test on 67 healthy controls and 133 patients: 15 with acute pancreatitis, 53 with chronic pancreatitis (20 during painful relapse and 33 in clinical remission), 18 with pancreatic cancer, 41 with nonpancreatic disease with abdominal pain, five with macroamylasemia, and one with total pancreatectomy. Results were compared with those of a wheat germ inhibition method and with electrophoresis on cellulose acetate. A close correlation was found between the results of immunoinhibition assay and those of the other two tests. All patients with acute pancreatitis had abnormally high values in all three tests. In the group with chronic pancreatitis studied during painful relapse, 16 had an increase in P-isoamylase, as determined with the immunoinhibition assay, 13 with the wheat germ inhibition test, and 15 with electrophoresis. In the group with chronic pancreatitis in clinical remission, we found low values in one patient, by immunoinhibition assay, but found low values in 17 and 19 patients by wheat germ inhibition and electrophoresis, respectively. Low P-isoamylase values corresponded to a severe exocrine pancreatic insufficiency. In the group with pancreatic cancer, the three tests showed similar results, and the majority of the patients had normal values. In the patients with nonpancreatic diseases, abnormally high levels were found in five, by immunoassay, in four by electrophoresis, and in three by the wheat germ inhibition method. In the five cases with macroamylasemia, both inhibition assays erroneously demonstrated an abnormal P-isoamylase elevation. The results show that the three tests are equally useful for the diagnosis of acute pancreatitis, or chronic pancreatitis during an acute relapse. In these diseases, the immunoinhibition test would be the preferred assay because it is simple and rapidly performed.
最近开发了一种使用两种针对唾液淀粉酶的单克隆抗体来测量血清胰腺（P）同工淀粉酶的方法。我们对67名健康对照者和133名患者进行了这项检测：15例急性胰腺炎患者、53例慢性胰腺炎患者（20例处于疼痛复发期，33例处于临床缓解期）、18例胰腺癌患者、41例伴有腹痛的非胰腺疾病患者、5例巨淀粉酶血症患者以及1例全胰切除术患者。将结果与麦胚抑制法和醋酸纤维素电泳法的结果进行了比较。发现免疫抑制测定结果与其他两种检测结果密切相关。所有急性胰腺炎患者在所有三项检测中值均异常高。在疼痛复发期研究的慢性胰腺炎组中，免疫抑制测定确定16例P同工淀粉酶升高，麦胚抑制试验确定13例升高，电泳确定15例升高。在临床缓解期的慢性胰腺炎组中，免疫抑制测定发现1例患者值低，但麦胚抑制法和电泳分别发现17例和19例患者值低。低P同工淀粉酶值对应严重的胰腺外分泌功能不全。在胰腺癌组中，三项检测结果相似，大多数患者值正常。在非胰腺疾病患者中，免疫测定发现5例异常高水平，电泳发现4例，麦胚抑制法发现3例。在5例巨淀粉酶血症病例中，两种抑制试验均错误地显示P同工淀粉酶异常升高。结果表明，这三项检测对急性胰腺炎或急性复发期慢性胰腺炎的诊断同样有用。在这些疾病中，免疫抑制试验将是首选检测方法，因为它操作简单且快速。
