Ruddell W S, Mitchell C J, Hamilton I, Leek J P, Kelleher J
Br Med J (Clin Res Ed). 1981 Nov 28;283(6304):1429-32. doi: 10.1136/bmj.283.6304.1429.
The clinical value of estimation of serum concentrations of immunoreactive trypsin was evaluated by studying 46 healthy controls, 23 controls in hospital, 44 patients with chronic pancreatic disease, and 184 patients with non-pancreatic conditions in which pancreatic disease commonly enters into the differential diagnosis. Serum trypsin concentration had a log normal distribution in the controls, and the calculated normal range was considerably wider than that previously reported. The concentration was abnormal in only 13 out of 27 patients with chronic pancreatitis and was extremely variable in patients with pancreatic cancer. Abnormal results occurred in 11% of the patients with non-pancreatic disease. Eighteen patients had a subnormal trypsin concentration, of whom six did not have pancreatic disease and 12 had either chronic pancreatitis or pancreatic cancer. There was no correlation between serum trypsin concentration and mean tryptic activity as measured by the Lundh test. Of 11 patients with pancreatic steatorrhoea, only seven had subnormal trypsin concentrations. There results suggest that the serum concentrations of immunoreactive trypsin has a low specificity and sensitivity for pancreatic disease and does no reflect the degree exocrine insufficiency in patients with proved chronic pancreatitis.
通过对46名健康对照者、23名住院对照者、44名慢性胰腺疾病患者以及184名患有通常需与胰腺疾病进行鉴别诊断的非胰腺疾病患者的研究，评估了免疫反应性胰蛋白酶血清浓度测定的临床价值。对照者的血清胰蛋白酶浓度呈对数正态分布，计算出的正常范围比先前报道的要宽得多。27名慢性胰腺炎患者中只有13名浓度异常，胰腺癌患者的浓度变化极大。11%的非胰腺疾病患者结果异常。18名患者胰蛋白酶浓度低于正常，其中6名没有胰腺疾病，12名患有慢性胰腺炎或胰腺癌。血清胰蛋白酶浓度与通过伦德试验测定的平均胰蛋白酶活性之间没有相关性。11名胰腺性脂肪泻患者中，只有7名胰蛋白酶浓度低于正常。这些结果表明，免疫反应性胰蛋白酶的血清浓度对胰腺疾病的特异性和敏感性较低，且不能反映已证实的慢性胰腺炎患者的外分泌不足程度。
