Sachdeva C K, Bank S, Greenberg R, Blumstein M, Weissman S
Long Island Jewish Medical Center, Albert Einstein College of Medicine, Division of Gastroenterology, New Hyde Park, New York, USA.
Am J Gastroenterol. 1995 May;90(5):800-3.
To report wide fluctuation of serum amylase in patients with macroamylasemia. It has generally been considered to remain constant.
Over the past 16 y, 18 patients have been diagnosed with macroamylasemia in our GI department. Of these, four patients were followed up with serial serum amylase determinations for a period of less than 1-4 y. Serum amylase was measured by the "Phadebas amylase test." Serum macroamylase was measured by "PEG precipitation technique."
There was a wide fluctuation of serum amylase in three out of four patients. In the fourth patient, more persistent hyperamylasemia was noted during the shorter observation period.
Marked fluctuation in serum amylase, ranging from 115 to 1160% in this study, may occur in patients with macroamylasemia. The reasons for these fluctuations are not clear but may be due to association-dissociation of amylase with serum proteins at variable time intervals. This fluctuation, especially when the amylase becomes normal (as in cases 1 and 3), may lead to confusion in differentiating macroamylasemia from other causes of hyperamylasemia.
报告巨淀粉酶血症患者血清淀粉酶的大幅波动情况。一般认为其血清淀粉酶水平保持恒定。
在过去16年中，我院消化内科诊断出18例巨淀粉酶血症患者。其中，4例患者接受了连续血清淀粉酶测定随访，随访期为1至4年。血清淀粉酶采用“法德巴斯淀粉酶试验”测定。血清巨淀粉酶采用“聚乙二醇沉淀技术”测定。
4例患者中有3例血清淀粉酶出现大幅波动。在第4例患者中，在较短观察期内观察到更为持续的高淀粉酶血症。
本研究中，巨淀粉酶血症患者血清淀粉酶可出现显著波动，波动范围为115%至1160%。这些波动的原因尚不清楚，但可能是由于淀粉酶与血清蛋白在不同时间间隔发生结合-解离所致。这种波动，尤其是当淀粉酶恢复正常时（如病例1和病例3），可能会导致在鉴别巨淀粉酶血症与其他高淀粉酶血症病因时产生混淆。
