Karbach U, Ewe K, Bodenstein H
Gut. 1983 Aug;24(8):718-23. doi: 10.1136/gut.24.8.718.
Intestinal protein loss is generally determined by radio-labelled macromolecules. Alpha 1-antitrypsin has been proposed as an endogenous marker for protein losing enteropathy, but different opinions exist about its reliability. In 25 patients with Crohn's disease faecal protein loss was studied with intestinal alpha 1-antitrypsin (alpha 1AT) clearance. Simultaneously, in 10 patients alpha 1AT clearance was compared with faecal 51Cr clearance after intravenous 51Cr-albumin injection. There was a linear relation (p less than 0.05) between alpha 1AT clearance and 51Cr clearance in these cases. In all patients alpha 1AT clearance was raised above control values. alpha 1AT clearance, however, did not correlate with the activity index of Crohn's disease. This index does not contain direct criteria of intestinal inflammation, does not take into account localisation or extent of inflammation, and includes complications such as extraintestinal manifestations, fistuli, stenoses not necessarily related to actual mucosal involvement. It is concluded that alpha 1AT is a reliable marker for intestinal protein loss and that the intestinal changes of Crohn's disease generally lead to an increased protein exudation into the gut.
肠道蛋白质丢失通常通过放射性标记的大分子来测定。α1-抗胰蛋白酶已被提议作为蛋白质丢失性肠病的内源性标志物，但关于其可靠性存在不同观点。对25例克罗恩病患者进行了肠道α1-抗胰蛋白酶（α1AT）清除率测定以研究粪便蛋白质丢失情况。同时，对10例患者静脉注射51Cr-白蛋白后，将α1AT清除率与粪便51Cr清除率进行了比较。在这些病例中，α1AT清除率与51Cr清除率之间存在线性关系（p<0.05）。所有患者的α1AT清除率均高于对照值。然而，α1AT清除率与克罗恩病的活动指数无关。该指数不包含肠道炎症的直接标准，未考虑炎症的定位或范围，且包括诸如肠外表现、瘘管、狭窄等并发症，而这些不一定与实际的黏膜受累相关。得出的结论是，α1AT是肠道蛋白质丢失的可靠标志物，克罗恩病的肠道改变通常会导致蛋白质向肠道内的渗出增加。
