Gullo L, Ventrucci M, Pezzilli R, Platé L, Naldoni P
Br J Surg. 1987 Jan;74(1):44-7. doi: 10.1002/bjs.1800740114.
We studied serum elastase 1 concentrations in patients with pancreatic disease to assess its diagnostic value and compare its sensitivity and specificity with that of amylase and pancreatic isoamylase. Markedly raised concentrations of elastase 1 were found in all twenty-nine patients with acute pancreatitis (amylase was elevated in all but three and pancreatic isoamylase in all but one). Serial measurements of the three enzymes in acute pancreatitis showed that elastase remained elevated longer than amylase and pancreatic isoamylase. The majority of chronic pancreatitis patients studied during a painful relapse (16 out of 21, 76 per cent) had elastase concentrations above the upper normal limit. Amylase and pancreatic isoamylase were elevated in 11 (52 per cent) and in 13 (62 per cent), respectively. Most patients with chronic pancreatitis studied during clinical remission (39 out of 43) had serum elastase levels either within (n = 24) or below (n = 15) the control range. The latter had severe exocrine pancreatic insufficiency and steatorrhoea. In carcinoma of the pancrease, 20 out of 32 (63 per cent) had abnormal serum elastase concentrations; 16 were higher and 4 lower than the control range. Amylase was abnormal in 10 (31 per cent) (8 high, 2 low), and pancreatic isoamylase was abnormal in 16 (50 per cent) (11 high, 5 low). In 46 control patients with non-pancreatic abdominal pain, serum elastase concentrations were not significantly different from those in healthy controls. Elastase was slightly raised in two, whereas amylase and pancreatic isoamylase were elevated in seven and eight, respectively. We conclude that serum elastase 1 is a highly sensitive and specific indicator of pancreatic disease.
我们研究了胰腺疾病患者的血清弹性蛋白酶1浓度，以评估其诊断价值，并将其敏感性和特异性与淀粉酶及胰腺同工淀粉酶进行比较。在所有29例急性胰腺炎患者中均发现弹性蛋白酶1浓度显著升高（除3例淀粉酶未升高外，其余均升高；除1例胰腺同工淀粉酶未升高外，其余均升高）。对急性胰腺炎患者的这三种酶进行连续测量显示，弹性蛋白酶升高的时间比淀粉酶和胰腺同工淀粉酶更长。在疼痛复发期间接受研究的大多数慢性胰腺炎患者（21例中的16例，76%）弹性蛋白酶浓度高于正常上限。淀粉酶和胰腺同工淀粉酶升高的患者分别有11例（52%）和13例（62%）。在临床缓解期接受研究的大多数慢性胰腺炎患者（43例中的39例）血清弹性蛋白酶水平在对照范围内（n = 24）或低于对照范围（n = 15）。后者存在严重的胰腺外分泌功能不全和脂肪泻。在胰腺癌患者中，32例中有20例（63%）血清弹性蛋白酶浓度异常；16例高于对照范围，4例低于对照范围。淀粉酶异常的有10例（31%）（8例升高，2例降低），胰腺同工淀粉酶异常的有16例（50%）（11例升高，5例降低）。在46例非胰腺性腹痛的对照患者中，血清弹性蛋白酶浓度与健康对照者无显著差异。2例弹性蛋白酶略有升高，而淀粉酶和胰腺同工淀粉酶升高的分别有7例和8例。我们得出结论，血清弹性蛋白酶1是胰腺疾病的高度敏感和特异的指标。
