Vezzadini P, Gullo L, Sternini C, Bonora G, Ferri G L, Labò G
Scand J Gastroenterol Suppl. 1980;62:29-34.
Serum immunoreactive trypsin (IRT) response to secretin injection was studied in 13 patients with chronic pancreatitis with different degrees of exocrine dysfunction and in 10 control subjects. The maximal increase of serum IRT from basal values and the integrated trypsin output (ITO) after secretin administration were significantly correlated with the output of chymotrypsin into the duodenum during caerulein-secretin infusion (p < 0.01), but not with the output of lipase nor of bicarbonate. Serum IRT response to secretin stimulation was greater in 4 of the 5 patients with chronic pancreatitis with mild to moderate exocrine dysfunction than in the control group, suggesting an increased regurgitation of IRT into the blood stream by the pancreas, probably due to some degree of obstruction to pancreatic secretory flow in absence of severe acinar cell damage. Conversely, the response of serum IRT after secretin administration in 7 of the 8 patients with severe exocrine pancreatic deficiency was lower than in control subjects, probably because of the advanced distruction of the acinar pancreatic tissue. The response of serum IRT to secretin stimulation seems to vary following pancreatic function impairment and might reflect the degree of pancreatic exocrine dysfunction in chronic pancreatitis.
对13例不同程度外分泌功能障碍的慢性胰腺炎患者和10名对照者进行了研究，观察血清免疫反应性胰蛋白酶（IRT）对注射促胰液素的反应。促胰液素给药后，血清IRT相对于基础值的最大增幅以及胰蛋白酶总输出量（ITO）与在蛙皮素 - 促胰液素输注期间胰凝乳蛋白酶进入十二指肠的输出量显著相关（p < 0.01），但与脂肪酶和碳酸氢盐的输出量无关。5例轻度至中度外分泌功能障碍的慢性胰腺炎患者中有4例对促胰液素刺激的血清IRT反应大于对照组，这表明胰腺IRT反流进入血流增加，可能是由于在没有严重腺泡细胞损伤的情况下胰腺分泌流存在一定程度的阻塞。相反，8例严重胰腺外分泌功能不全患者中有7例在促胰液素给药后血清IRT反应低于对照者，这可能是由于胰腺腺泡组织的严重破坏。血清IRT对促胰液素刺激的反应似乎随胰腺功能损害而变化，可能反映慢性胰腺炎中胰腺外分泌功能障碍的程度。
