Poston G J, Adamson A S, Heeley A F, Heeley M E, Hughes E, Benjamin I S
Royal Postgraduate Medical School, London.
Ann R Coll Surg Engl. 1987 Sep;69(5):205-8.
Immunoreactive trypsin (IRT) was measured in the serum of patients presenting with acute pancreatitis (AP) and compared to serum amylase levels. Both were elevated beyond the normal range at presentation (mean IRT 557 +/- 252 micrograms/l, range 181-1000 micrograms/l, mean control IRT 42 +/- 14 micrograms/l, range 15-82 micrograms/l; mean amylase 4500 +/- 3200 IU/l, range 600-10,500 IU/l, control amylase mean 175 +/- 43 IU/l, range 48-320 IU/l). There was minimal correlation between IRT and amylase elevation but both returned to normal at the same rate in patients who recovered. In 2 patients with persistently elevated IRT levels, one was found to have a pancreatic pseudocyst and the other subsequently died from alcoholic haemorrhagic pancreatitis. IRT is no better than amylase as a single diagnostic assay in AP but may be greatly elevated when amylase elevation is minimal. The combination of the two may improve diagnostic accuracy and persistent elevation of IRT may be of prognostic importance.
在患有急性胰腺炎（AP）的患者血清中检测免疫反应性胰蛋白酶（IRT），并与血清淀粉酶水平进行比较。两者在就诊时均高于正常范围（平均IRT为557±252微克/升，范围为181 - 1000微克/升，对照平均IRT为42±14微克/升，范围为15 - 82微克/升；平均淀粉酶为4500±3200国际单位/升，范围为600 - 10500国际单位/升，对照淀粉酶平均为175±43国际单位/升，范围为48 - 320国际单位/升）。IRT升高与淀粉酶升高之间的相关性极小，但在康复患者中两者以相同速率恢复正常。在2例IRT水平持续升高的患者中，1例发现有胰腺假性囊肿，另1例随后死于酒精性出血性胰腺炎。在急性胰腺炎中，IRT作为单一诊断检测方法并不比淀粉酶更好，但当淀粉酶升高极小时，IRT可能会大幅升高。两者联合使用可能会提高诊断准确性，IRT持续升高可能具有预后意义。
