Geokas M C, Rinderknecht H, Brodrick J W, Largman C
Am J Dig Dis. 1978 Feb;23(2):182-8. doi: 10.1007/BF01073198.
Total protein, alpha1-antitrypsin, alpha2-macroglobulin, amylase, methemalbumin, tryptic amidase activity, radioimmunoassayable elastase 2, and three lysosomal hydrolases were determined in the ascites fluid from patients with acute pancreatitis. In eight patients methemalbumin was detected in ascites and serum, supporting the diagnosis of hemorrhagic pancreatitis. Significant levels (4-45 microgram/ml) of tryptic amidase activity were detected in ascites samples from all patients. Evidence is presented which demonstrates that the tryptic amidase activity is due to alpha2-macroglobulin-bound trypsin. Pancreatic elastase 2, determined with a new sensitive and specific radioimmunoassay, ranged from 400 to 2100 ng/ml in serum and from 650 to 4460 ng/ml in ascites fluid. Substantial amounts of alpha2-macroglobulin-bound trypsin and elastase 2, entering the circulation from the peritoneal cavity, might be responsible for certain serious complications seen in acute pancreatitis. However, with the exception of serum calcium and methemalbumin and the ascites fluid methemalbumin and total protein, none of the biochemical parameters studied showed a distinct correlation with the patient's outcome.
对急性胰腺炎患者的腹水进行了总蛋白、α1-抗胰蛋白酶、α2-巨球蛋白、淀粉酶、高铁血红蛋白、胰蛋白酶酰胺酶活性、放射免疫法可测定的弹性蛋白酶2以及三种溶酶体水解酶的检测。8例患者的腹水和血清中检测到高铁血红蛋白，支持出血性胰腺炎的诊断。在所有患者的腹水样本中均检测到显著水平（4 - 45微克/毫升）的胰蛋白酶酰胺酶活性。有证据表明，胰蛋白酶酰胺酶活性是由与α2-巨球蛋白结合的胰蛋白酶引起的。用一种新的灵敏且特异的放射免疫法测定的胰腺弹性蛋白酶2，血清中范围为400至2100纳克/毫升，腹水中为650至4460纳克/毫升。大量与α2-巨球蛋白结合的胰蛋白酶和弹性蛋白酶2从腹腔进入循环，可能是急性胰腺炎中某些严重并发症的原因。然而，除了血清钙、高铁血红蛋白以及腹水的高铁血红蛋白和总蛋白外，所研究的生化参数均未显示与患者的预后有明显相关性。
