Thomas D W, Sinatra F R, Merritt R J
Gastroenterology. 1981 Apr;80(4):776-82.
Random fecal alpha-1-antitrypsin concentration was measured in children with various gastrointestinal diseases and in normal subjects. One hundred fifteen subjects were evaluated: controls (39); chronic inflammatory bowel disease (20); chronic diarrhea (18); acute gastroenteritis (17); allergic gastroenteropathy (5); chronic pancreatic exocrine insufficiency (4); acute gastrointestinal bleeding (4); nonspecific colitis (4); celiac disease (3); and intestinal lymphangiectasia (1). Mean fecal-alpha-1-antitrypsin for the controls was 0.98 mg/g lyophilized stool. All children with celiac disease, allergic gastroenteropathy, lymphangiectasia, nonspecific colitis, acute gastrointestinal bleeding, and 19 of 20 patients with active chronic inflammatory bowel disease had fecal alpha-1-antitrypsin concentrations greater than 2.6 mg/g stool (mean of the controls + 2 SD). These disorders have all been previously documented to cause protein-losing enteropathy by 51Cr-labeled albumin excretion tests. The other study patients had normal fecal alpha-1-antitrypsin excretion when compared with controls. Serial fecal antitrypsin concentrations paralleled disease activity and clinical response to therapy. The results suggest that random fecal antitrypsin concentration is a valuable screening test for mucosal disorders associated with abnormal transmucosal serum protein loss.
对患有各种胃肠道疾病的儿童和正常受试者测定了随机粪便α-1-抗胰蛋白酶浓度。共评估了115名受试者：对照组（39名）；慢性炎症性肠病（20名）；慢性腹泻（18名）；急性胃肠炎（17名）；过敏性胃肠病（5名）；慢性胰腺外分泌功能不全（4名）；急性胃肠道出血（4名）；非特异性结肠炎（4名）；乳糜泻（3名）；以及肠淋巴管扩张症（1名）。对照组的平均粪便α-1-抗胰蛋白酶为0.98mg/g冻干粪便。所有患有乳糜泻、过敏性胃肠病、淋巴管扩张症、非特异性结肠炎、急性胃肠道出血的儿童，以及20名活动性慢性炎症性肠病患者中的19名，其粪便α-1-抗胰蛋白酶浓度均高于2.6mg/g粪便（对照组平均值+2个标准差）。这些疾病此前均已通过51Cr标记白蛋白排泄试验证实可导致蛋白丢失性肠病。与对照组相比，其他研究患者的粪便α-1-抗胰蛋白酶排泄正常。连续粪便抗胰蛋白酶浓度与疾病活动度及治疗的临床反应平行。结果表明，随机粪便抗胰蛋白酶浓度是一种用于筛查与经黏膜血清蛋白异常丢失相关的黏膜疾病的有价值的检测方法。
