Ventrucci M, Pezzilli R, Naldoni P, Platè L, Baldoni F, Gullo L, Barbara L
Institute of Medicine and Gastroenterology, University of Bologna, Italy.
Pancreas. 1987;2(5):506-9. doi: 10.1097/00006676-198709000-00003.
The variations of serum levels of amylase, pancreatic isoamylase, lipase, trypsinogen, and elastase 1 were evaluated in 21 patients with acute pancreatitis. The patients were studied for a mean period of 7 consecutive days (range 5-12 days) after admission to the hospital. On the day of onset of acute pancreatitis, all enzyme levels were abnormally high; pancreatic isoamylase showed the greatest increase compared with its upper normal limit, whereas the increase increment for elastase 1 was the lowest. Subsequently, all enzyme levels except elastase 1 decreased in a parallel fashion. On the eighth day of the study only elastase 1 levels were above normal values in all patients examined, while abnormally high values of lipase were found in 85% of the patients, trypsinogen in 58% of the patients, pancreatic isoamylase in 43%, and total amylase in 23%. These results indicate that, for the early diagnosis of acute pancreatitis, the determination of any of these enzymes is equally efficient, but that elastase 1 is the most sensitive marker of acute pancreatic damage in later stages of the disease.
对21例急性胰腺炎患者的血清淀粉酶、胰腺同工淀粉酶、脂肪酶、胰蛋白酶原和弹性蛋白酶1水平的变化进行了评估。患者在入院后平均连续研究7天（范围5 - 12天）。在急性胰腺炎发病当天，所有酶水平均异常升高；胰腺同工淀粉酶与其正常上限相比升高幅度最大，而弹性蛋白酶1的升高幅度最低。随后，除弹性蛋白酶1外，所有酶水平均呈平行下降。在研究的第8天，所有接受检查的患者中只有弹性蛋白酶1水平高于正常值，而85%的患者脂肪酶值异常高，58%的患者胰蛋白酶原值异常高，43%的患者胰腺同工淀粉酶值异常高，23%的患者总淀粉酶值异常高。这些结果表明，对于急性胰腺炎的早期诊断，测定这些酶中的任何一种同样有效，但弹性蛋白酶1是该疾病后期急性胰腺损伤最敏感的标志物。
