Benini L, Rizzotti P, Vaona B, Vantini I, Sembenini C, Marini M, Brocco G, Cavallini G, Scuro L A
Clinica Medica e Centro di Enzimologia Clinica, Verona, Italia.
J Clin Chem Clin Biochem. 1988 Aug;26(8):527-9.
Using an immunoenzymatic method, we studied lipase in the serum and urine of 23 controls, 22 chronic pancreatitis patients in symptomatic remission, and in 9 patients with proven pancreatic cancer. Serum and urine lipase and its fractional urinary clearance were compared with those of amylase and immunoreactive trypsin. Lipase immunoreactivity was detectable in the urine of 81.5% of the studied subjects (controls: 82%, chronic pancreatitis: 86%, pancreatic cancer: 66%); its output was higher than the upper limit of controls in 31.8% of chronic pancreatitis and in only 1 of pancreatic cancer, and it was significantly correlated with the urinary output of trypsin (r = 0.487, P less than 0.001), but not with that of amylase. A significant correlation was found between urinary output and serum levels for lipase, but not for trypsin or amylase. Fractional clearance of lipase was of the same magnitude as that of trypsin but only 0.1% that of amylase. 19% of chronic pancreatitis and pancreatic cancer showed a fractional clearance of lipase above the upper limit of controls, compared with 45% for trypsin and 3.2% for amylase. No difference in urinary clearance of the three enzymes was found between chronic pancreatitis and pancreatic cancer. In conclusion, although of no diagnostic relevance in pain-free patients with chronic pancreatic disease, this measurement can provide information on the mechanisms of renal excretion of pancreatic enzymes.
我们采用免疫酶法，对23名对照者、22名处于症状缓解期的慢性胰腺炎患者以及9名确诊为胰腺癌的患者的血清和尿液中的脂肪酶进行了研究。将血清和尿液中的脂肪酶及其尿清除率分数与淀粉酶和免疫反应性胰蛋白酶的进行了比较。在所研究的受试者中，81.5%的人尿液中可检测到脂肪酶免疫反应性（对照者：82%，慢性胰腺炎：86%，胰腺癌：66%）；在31.8%的慢性胰腺炎患者中其排出量高于对照者上限，而在胰腺癌患者中只有1例如此，并且它与胰蛋白酶的尿排出量显著相关（r = 0.487，P < 0.001），但与淀粉酶的尿排出量无关。脂肪酶的尿排出量与血清水平之间存在显著相关性，但胰蛋白酶或淀粉酶则不然。脂肪酶的清除率分数与胰蛋白酶的相同，但仅为淀粉酶的0.1%。19%的慢性胰腺炎和胰腺癌患者脂肪酶清除率分数高于对照者上限，相比之下，胰蛋白酶为45%，淀粉酶为3.2%。慢性胰腺炎和胰腺癌患者之间这三种酶的尿清除率没有差异。总之，尽管对于无疼痛的慢性胰腺疾病患者没有诊断意义，但这种测量可以提供有关胰腺酶肾排泄机制的信息。
