Pelletier G, Née N, Brivet M, Ponsot P
Gastroenterol Clin Biol. 1984 Nov;8(11):792-5.
The purpose of this work was: a) the prospective study of the prevalence of hyperamylasemia in 100 patients with chronic alcoholism; b) the determination of the serum isoamylase distribution in patients with hyperamylasemia by an inhibitor assay; c) the search of the origin of elevated serum isoamylase S. Moderate hyperamylasemia was found in 15 patients. The importance of alcohol abuse, the prevalences of cirrhosis and smokers were not statistically different from those observed in normoamylasemic patients. After one week of hospitalization, serum amylase was still elevated in 11 of 14 alcoholic patients. Hyperamylasemia was due to an increase in the isoamylase P in 5 cases, in the isoamylase S in 7 cases, and in both forms in 3 cases. Activities of serum lipase and isoamylase P were roughly parallel. Only two out of 8 patients with elevated isoamylase P had chronic pancreatitis. The salivary origin of elevated isoamylase S was suspected in only one out of 10 patients. This work shows that the origin of moderate hyperamylasemia, observed in alcoholic patients, is often extrapancreatic. It is suggested that the dosage of serum lipase simpler than that of isoamylases, may be routinely used in chronic alcoholic patients for diagnostic purposes.
a）对100例慢性酒精中毒患者高淀粉酶血症的患病率进行前瞻性研究；b）通过抑制剂测定法确定高淀粉酶血症患者血清同工淀粉酶的分布；c）探寻血清同工淀粉酶S升高的来源。15例患者出现中度高淀粉酶血症。酒精滥用、肝硬化患病率及吸烟者比例与正常淀粉酶血症患者相比，在统计学上无差异。14例酒精性患者中有11例在住院一周后血清淀粉酶仍升高。5例高淀粉酶血症是由于同工淀粉酶P升高，7例是由于同工淀粉酶S升高，3例是两种形式均升高。血清脂肪酶和同工淀粉酶P的活性大致平行。8例同工淀粉酶P升高的患者中只有2例患有慢性胰腺炎。10例患者中只有1例怀疑升高的同工淀粉酶S来源于唾液。这项研究表明，在酒精性患者中观察到的中度高淀粉酶血症，其来源通常是胰腺外的。建议血清脂肪酶的检测比同工淀粉酶检测更简单，可常规用于慢性酒精性患者的诊断。
