慢性肾衰竭中的胰腺酶

Pancreatic enzymes in chronic renal failure.

作者信息

Royse V L, Jensen D M, Corwin H L

出版信息

Arch Intern Med. 1987 Mar;147(3):537-9.

Abstract

Serum was obtained from 55 patients, including 43 with stable chronic renal failure (CRF) (28 receiving chronic hemodialysis [CHD] and 15 receiving chronic ambulatory peritoneal dialysis [CAPD]), nine with peritonitis receiving CAPD, and three with pancreatitis receiving CAPD. Total serum amylase activity, lipase activity, isoamylase fractionation, and lipase concentration were used to measure pancreatic enzymes. Amylase activity was increased in 35 of 43 patients with CRF but was greater than threefold elevated in only three. Pancreatic isoamylase activity was greater than 80% in only one patient with CRF but was greater than 80% in all three patients with pancreatitis receiving CAPD. Lipase activity was increased in 26 patients and lipase concentration was elevated in 27. Peritoneal fluid from three patients with pancreatitis receiving CAPD contained high levels of amylase. Serum amylase and lipase are frequently elevated in patients with CRF in the absence of clinical pancreatitis. However, serum amylase activity greater than threefold elevated or the presence of pancreatic enzymes in the peritoneal fluid may suggest coexistent pancreatitis.

摘要

从55例患者中获取血清，其中包括43例稳定的慢性肾衰竭（CRF）患者（28例接受慢性血液透析[CHD]，15例接受持续性非卧床腹膜透析[CAPD]），9例接受CAPD的腹膜炎患者，以及3例接受CAPD的胰腺炎患者。采用总血清淀粉酶活性、脂肪酶活性、同工淀粉酶分级和脂肪酶浓度来检测胰腺酶。43例CRF患者中有35例淀粉酶活性升高，但只有3例升高超过三倍。仅1例CRF患者的胰腺同工淀粉酶活性大于80%，但所有3例接受CAPD的胰腺炎患者的胰腺同工淀粉酶活性均大于80%。26例患者脂肪酶活性升高，27例患者脂肪酶浓度升高。3例接受CAPD的胰腺炎患者的腹水中淀粉酶水平较高。在无临床胰腺炎的CRF患者中，血清淀粉酶和脂肪酶经常升高。然而，血清淀粉酶活性升高超过三倍或腹水中存在胰腺酶可能提示合并胰腺炎。