Hörl W H, Wanner C, Schollmeyer P, Ogawa M
Department of Medicine, University of Freiburg, FRG.
Nephron. 1988;49(1):33-8. doi: 10.1159/000184983.
Plasma levels of pancreatic secretory trypsin inhibitor (PSTI), lipase and amylase were measured in patients with chronic renal failure (CRF), patients undergoing regular hemodialysis treatment (RDT) or continuous ambulatory peritoneal dialysis (CAPD), patients with acute renal failure (ARF) and patients following successful cadaveric kidney transplantation. Plasma PSTI values were 9.2 +/- 0.8 ng/ml in controls (CO), 156.9 +/- 16.2 ng/ml in CRF patients, 257.6 +/- 22.3 ng/ml in RDT patients, 376.8 +/- 57.5 ng/ml in CAPD patients and 2,300 +/- 276.9 ng/ml in patients with posttraumatic ARF. RDT patients with malignant diseases displayed significantly higher PSTI values (1,014 +/- 148.7 ng/ml; p less than 0.01) than RDT patients without malignancy. Transplant patients with normal kidney function (creatinine 1.25 +/- 0.1 mg/dl) showed significantly lower PSTI values (16.7 +/- 2.1 ng/ml) than transplant patients with impaired renal function (creatinine 4.7 +/- 0.5 mg/dl; PSTI 72.8 +/- 11.8 ng/ml; p less than 0.01). Daily urinary excretion of PSTI increased from 26.7 +/- 3.1 micrograms (CO) to 551.8 +/- 54.8 micrograms in CRF patients. In CAPD patients, daily peritoneal loss of PSTI was 164.3 +/- 58.4 micrograms. Plasma PSTI values increased during hemodialysis with dialyzers made of cuprophan (317.0 +/- 32.6 vs. 422.0 +/- 46.2 ng/ml; p less than 0.05) and decreased with polysulfone dialyzers (226.6 +/- 19.9 vs. 86.6 +/- 18.1 ng/ml). There was no correlation between PSTI and urea, creatinine, lipase or amylase in each tested group. Our results document markedly elevated plasma PSTI values in all forms of renal insufficiency, suggesting extrapancreatic PSTI production and/or reduced renal elimination.
我们检测了慢性肾衰竭（CRF）患者、接受定期血液透析治疗（RDT）或持续性非卧床腹膜透析（CAPD）的患者、急性肾衰竭（ARF）患者以及尸体肾移植成功后的患者血浆中胰腺分泌性胰蛋白酶抑制剂（PSTI）、脂肪酶和淀粉酶的水平。对照组（CO）血浆PSTI值为9.2±0.8 ng/ml，CRF患者为156.9±16.2 ng/ml，RDT患者为257.6±22.3 ng/ml，CAPD患者为376.8±57.5 ng/ml，创伤后ARF患者为2300±276.9 ng/ml。患有恶性疾病的RDT患者的PSTI值（1014±148.7 ng/ml；p＜0.01）显著高于无恶性疾病的RDT患者。肾功能正常（肌酐1.25±0.1 mg/dl）的移植患者的PSTI值（16.7±2.1 ng/ml）显著低于肾功能受损（肌酐4.7±0.5 mg/dl；PSTI 72.8±11.8 ng/ml；p＜0.01）的移植患者。CRF患者的PSTI每日尿排泄量从26.7±3.1微克（CO）增加到551.8±54.8微克。在CAPD患者中，PSTI的每日腹膜丢失量为164.3±58.4微克。使用铜仿膜制成的透析器进行血液透析期间，血浆PSTI值升高（317.0±32.6与422.0±46.2 ng/ml；p＜0.05），而使用聚砜透析器时则降低（226.6±19.9与86.6±18.1 ng/ml）。在每个测试组中，PSTI与尿素、肌酐、脂肪酶或淀粉酶之间均无相关性。我们的结果表明，在所有形式的肾功能不全中，血浆PSTI值均显著升高，提示胰腺外PSTI产生增加和/或肾脏清除减少。
