Dockter G, Sitzmann F C
Monatsschr Kinderheilkd. 1980 Dec;128(12):732-8.
To establish the diagnosis of acute pancreatitis the estimation of amylase in serum and urine, lipase and radio-immunoreactive trypsin in the serum are useful. Lipase estimations are more helpful than measuring amylase values. Trypsin-RIA-tests are increasingly important adults. But in chronic pancreatitis and inborn secretory insufficiencies of the pancreas these methods are less helpful. PABA-test, pancreolauryl-test (PLT), and the estimation of chymotrypsin in faeces are screening procedures, although their results correlate well amongst each other. As compared to the chymotrypsin estimation in faeces PABA test and PLT allow for some semiquantitative estimation of the secretory function and dynamics of the gland. The influence of malabsorption, liver and kidney diseases on these parameters is not yet quite clarified. Besides screening they are undoubtedly of value for judging the course and therapy of cystic fibrosis, Shwachman-syndrome, iatrogenic lesions by cytostatics (immunosuppressives and corticosteroids). Quantitative estimations of fat in faces and the pancreozymin test are no longer of significance.
为确立急性胰腺炎的诊断,检测血清和尿液中的淀粉酶、血清中的脂肪酶及放射免疫活性胰蛋白酶很有用。脂肪酶检测比淀粉酶检测更有帮助。胰蛋白酶放射免疫分析检测对成人越来越重要。但在慢性胰腺炎和先天性胰腺分泌功能不全时,这些方法的帮助较小。对氨基苯甲酸试验、胰功肽试验(PLT)以及粪便中糜蛋白酶的检测均为筛查程序,尽管它们的结果相互之间相关性良好。与粪便中糜蛋白酶检测相比,对氨基苯甲酸试验和胰功肽试验能对胰腺的分泌功能和动态进行一些半定量评估。吸收不良、肝脏和肾脏疾病对这些参数的影响尚未完全阐明。除筛查外,它们无疑对判断囊性纤维化、施瓦茨曼综合征、细胞毒性药物(免疫抑制剂和皮质类固醇)所致医源性损害的病程及治疗有价值。粪便中脂肪的定量检测和促胰液素试验已不再有意义。