Mero M, Schröder T, Tenhunen R, Lempinen M
Scand J Gastroenterol. 1982 Apr;17(3):413-6. doi: 10.3109/00365528209182078.
Serum immunoreactive trypsin and phospholipase A2 were analyzed at regular intervals in seven patients hospitalized as a result of acute hemorrhage pancreatitis. alpha 1-Antitrypsin and alpha 2-macroglobulin levels and trypsin-inhibitor capacity of serum were determined simultaneously. Serum trypsin concentrations were markedly raised in all patients. The levels of immunoreactive trypsin remained elevated for longer periods than those of urinary amylase. alpha 1-Antitrypsin and trypsin-inhibitor capacity were also significantly increased as compared with the post-illness values, but alpha 2-macroglobulin decreased considerably, reaching the lowest levels on the 5th day after admission. Consequently, phospholipase and trypsin are released to the circulation during hemorrhagic pancreatitis, but the increase in trypsin is compensated for by an increase in trypsin-inhibitor capacity of serum due to elevated alpha 1-antitrypsin levels. The decrease of alpha 2-macroglobulin in hemorrhagic pancreatitis was one of the most interesting findings, and it is proposed that this inhibitor may be consumed in the elimination of proteases through the reticuloendothelial system. The two patients who died had higher phospholipase values than those who recovered, but the prognosis could not be predicted from the values of the other measured variables.
对7例因急性出血性胰腺炎住院的患者定期检测血清免疫反应性胰蛋白酶和磷脂酶A2。同时测定血清α1-抗胰蛋白酶、α2-巨球蛋白水平及胰蛋白酶抑制能力。所有患者血清胰蛋白酶浓度均显著升高。免疫反应性胰蛋白酶水平升高的持续时间比尿淀粉酶更长。与病后值相比，α1-抗胰蛋白酶和胰蛋白酶抑制能力也显著增加，但α2-巨球蛋白明显降低，在入院后第5天降至最低水平。因此，在出血性胰腺炎期间磷脂酶和胰蛋白酶释放入循环，但由于α1-抗胰蛋白酶水平升高，血清胰蛋白酶抑制能力增加，可弥补胰蛋白酶的增加。出血性胰腺炎时α2-巨球蛋白的降低是最有趣的发现之一，推测该抑制剂可能通过网状内皮系统在清除蛋白酶的过程中被消耗。两名死亡患者的磷脂酶值高于康复患者，但无法根据其他测量变量的值预测预后。
