Ventrucci M, Gullo L, Daniele C, Bartolucci C, Priori P, Platé L, Bonora G, Labò G
Digestion. 1983;28(2):114-21. doi: 10.1159/000198973.
Serum total amylase, pancreatic and salivary isoamylase, lipase and trypsin-like immunoreactivity (TLI) were measured in 16 patients with acute pancreatitis, 37 patients with chronic pancreatitis, 11 patients with pancreatic cancer, and 53 control subjects in order to evaluate the relative value of these tests in the diagnosis of pancreatic disease. In acute pancreatitis patients studied within 2 days from the onset of pain all pancreatic enzymes were abnormally high. In chronic pancreatitis patients serum pancreatic isoamylase and TLI were abnormally low in 8 out of 10 patients with severely impaired pancreatic exocrine function, while lipase was abnormally low in 6 patients. During acute exacerbations of the disease elevated levels of pancreatic isoamylase and lipase, but not of TLI, were found in about one third of cases. In patients with pancreatic cancer the pattern of changes in serum pancreatic enzymes was variable since levels within, below and above the normal range were found. The results demonstrate that in acute pancreatitis all serum pancreatic enzymes had the same diagnostic sensitivity, however serum lipase determination is the most convenient because of its simplicity and low cost. In chronic pancreatitis serum pancreatic isoamylase and TLI may be useful in detecting severe pancreatic insufficiency. In pancreatic cancer serum pancreatic enzymes lack diagnostic specificity.
对16例急性胰腺炎患者、37例慢性胰腺炎患者、11例胰腺癌患者及53名对照者测定了血清总淀粉酶、胰腺及唾液淀粉酶同工酶、脂肪酶和胰蛋白酶样免疫反应性（TLI），以评估这些检测在胰腺疾病诊断中的相对价值。在疼痛发作后2天内进行研究的急性胰腺炎患者中，所有胰腺酶均异常升高。在慢性胰腺炎患者中，10例胰腺外分泌功能严重受损的患者中有8例血清胰腺淀粉酶同工酶和TLI异常降低，而脂肪酶有6例异常降低。在疾病急性发作期间，约三分之一的病例发现胰腺淀粉酶同工酶和脂肪酶水平升高，但TLI未升高。在胰腺癌患者中，血清胰腺酶的变化模式各不相同，因为发现其水平在正常范围内、低于正常范围和高于正常范围。结果表明，在急性胰腺炎中，所有血清胰腺酶具有相同的诊断敏感性，然而血清脂肪酶测定因其简便性和低成本而最为方便。在慢性胰腺炎中，血清胰腺淀粉酶同工酶和TLI可能有助于检测严重的胰腺功能不全。在胰腺癌中，血清胰腺酶缺乏诊断特异性。
