Manes G, Ricci E, Rabitti P G, Caruso S, Carraturo I, Laccetti M, Uomo G
Centro Malattie Pancreas, Ospedale Cardarelli di Napoli.
Minerva Gastroenterol Dietol. 1994 Sep;40(3):113-7.
The aim of this study was to evaluate which of serum pancreatic enzymes was less influenced by chronic renal failure (CRF).
40 patients with CRF undergoing hemodialysis (A group) and 24 renal transplant patients (B group) were considered. None of these patients showed clinical and instrumental findings of exocrine pancreas disease. Total amylase (T Amy), pancreatic isoamylase (P Amy), lipase (L) and Elastase-1 (E-1) were measured (in A group immediately before hemodialysis).
In A group T Amy and P Amy showed a significant correlation with serum creatinine level. In A group T Amy serum levels were increased in 65% of cases, P Amy in 72.5%, L in 47.5%, E-1 in 10%; in B group T Amy serum levels were increased in 41.6%, P Amy in 20.1%, L in 8.3% and E-1 in 4.1%. Statistical comparison showed a significantly lower percentages in B group considering P Amy (p < 0.001) and L (p = 0.003).
Our data suggest that E-1 is the only pancreatic enzyme whose specificity is not limited by CRF and thereby may be of value in the diagnosis of the exocrine pancreatic disease in patients with CRF on hemodialysis.
本研究旨在评估哪种血清胰酶受慢性肾衰竭（CRF）的影响较小。
纳入40例接受血液透析的CRF患者（A组）和24例肾移植患者（B组）。这些患者均未表现出胰腺外分泌疾病的临床和影像学表现。检测总淀粉酶（T Amy）、胰型淀粉酶（P Amy）、脂肪酶（L）和弹性蛋白酶-1（E-1）（A组在血液透析前即刻检测）。
A组中，T Amy和P Amy与血清肌酐水平呈显著相关。A组中，65%的病例T Amy血清水平升高，72.5%的病例P Amy升高，47.5%的病例L升高，10%的病例E-1升高；B组中，41.6%的病例T Amy血清水平升高，20.1%的病例P Amy升高，8.3%的病例L升高，4.1%的病例E-1升高。统计学比较显示，B组中P Amy（p < 0.001）和L（p = 0.003）的升高百分比显著更低。
我们的数据表明，E-1是唯一一种特异性不受CRF限制的胰酶，因此可能对诊断接受血液透析的CRF患者的胰腺外分泌疾病具有价值。
