Layer P, Hotz J, Noske A, Goebell H
Digestion. 1986;34(1):22-7. doi: 10.1159/000199306.
Chronic pancreatitis has been reported to be associated with an increased secretion of calcium in pancreatic juice. To determine whether estimation of duodenal calcium may be useful for diagnosing chronic pancreatitis, we compared duodenal calcium output in patients with chronic pancreatitis and in subjects without pancreatic disease, during intravenous infusion of secretion alone, with calcium, or with cholecystokinin-pancreozymin (CCK-PZ). Duodenal calcium output increased during infusion of both calcium and CCK-PZ to a similar extent in chronic pancreatitis and controls. Overall, duodenal output of chymotrypsin was markedly lower in chronic pancreatitis; however, chymotrypsin output increased in response to both intravenous calcium and CCK-PZ in both groups. Bilirubin output increased in both groups during calcium infusion, but this increase was significantly reduced in chronic pancreatitis; in contrast, CCK-PZ caused a similar increase in both groups. The high calcium output observed in hypercalcemia in the presence of low enzyme output suggests increased pancreatic secretion of enzyme-independent calcium in chronic pancreatitis. However, the difference is obscured by biliary calcium, which is secreted in much higher concentrations. Thus, duodenal calcium determination does not appear to be a useful diagnostic test in chronic pancreatitis.
据报道，慢性胰腺炎与胰液中钙分泌增加有关。为了确定十二指肠钙测定对诊断慢性胰腺炎是否有用，我们比较了慢性胰腺炎患者和无胰腺疾病受试者在单独静脉输注分泌液、钙或胆囊收缩素-促胰液素（CCK-PZ）期间的十二指肠钙输出量。在慢性胰腺炎患者和对照组中，输注钙和CCK-PZ期间十二指肠钙输出量增加的程度相似。总体而言，慢性胰腺炎患者胰凝乳蛋白酶的十二指肠输出量明显较低；然而，两组中静脉输注钙和CCK-PZ后胰凝乳蛋白酶输出量均增加。两组在输注钙期间胆红素输出量均增加，但慢性胰腺炎患者的这种增加明显减少；相比之下，CCK-PZ在两组中引起的增加相似。在酶输出量低的情况下，高钙血症中观察到的高钙输出表明慢性胰腺炎中胰腺分泌与酶无关的钙增加。然而，这种差异被浓度高得多的胆汁钙所掩盖。因此，十二指肠钙测定似乎不是慢性胰腺炎的有用诊断试验。
