肝外门静脉阻塞中的胰腺功能减退
Pancreatic hypofunction in extrahepatic portal venous obstruction.
作者信息
Webb L, Smith-Laing G, Lake-Bakaar G, McKavanagh S, Sherlock S
出版信息
Gut. 1980 Mar;21(3):227-31. doi: 10.1136/gut.21.3.227.
Pancreatic function was studied in 29 patients with extrahepatic portal venous obstruction, and 30 age-matched controls. The aetiology of the portal venous obstruction was known in 20 out of 29 patients. No patient had a history of pancreatitis. Serum trypsin, both fasting and for 120 minutes after a Lundh meal, was significantly lower in the patients than in controls (P less than 0.005). 5/28 (18%) patients had reduced fasting serum trypsin levels and in 5/14 trypsin was abnormal after a Lundh meal. Mean fasting serum glucose (3.8 +/- ).49 mmol/l was significantly higher than in control subjects (mean 3.4 +/- 0.42 mmol/l) (P less than 0.05). After 100 g glucose orally, mean serum glucose at 180 minutes (5.26 +/- 1.58 mmol/l) was higher than the control value (3.96 +/- 1.45 mmol/l) (P less than 0.05), and 30 and 60 minutes serum C-peptide values were significantly lower (P less than 0.005). Pancreatic hypofunction found in these patients probably results from an abnormal portal circulation in association with mild pancreatic damage secondary to chronic venous congestion.
对29例肝外门静脉阻塞患者及30例年龄匹配的对照者的胰腺功能进行了研究。29例患者中有20例门静脉阻塞的病因明确。所有患者均无胰腺炎病史。患者空腹及在进行伦德餐试验120分钟后的血清胰蛋白酶水平均显著低于对照组（P<0.005）。28例患者中有5例（18%）空腹血清胰蛋白酶水平降低，14例患者中有5例在进行伦德餐试验后胰蛋白酶异常。患者空腹血清葡萄糖平均水平（3.8±0.49 mmol/L）显著高于对照者（平均3.4±0.42 mmol/L）（P<0.05）。口服100克葡萄糖后，180分钟时的血清葡萄糖平均水平（5.26±1.58 mmol/L）高于对照值（3.96±1.45 mmol/L）（P<0.05），且30分钟和60分钟时的血清C肽值显著降低（P<0.005）。这些患者中发现的胰腺功能减退可能是由于门静脉循环异常，伴有慢性静脉淤血继发的轻度胰腺损伤。
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