Domschke S, Malfertheiner P, Uhl W, Büchler M, Domschke W
Department of Medicine, University of Münster, Germany.
Int J Pancreatol. 1993 Apr;13(2):105-10. doi: 10.1007/BF02786078.
Serum concentrations of free fatty acids (FFA) were assayed in 20 patients with acute necrotizing pancreatitis (ANP). Pancreatic and peripancreatic fat necrosis was verified on operation and/or by contrast-enhanced computed tomography. For comparison, 20 patients with acute edematous pancreatitis (AEP) were examined. On admission, FFA serum levels were 1.14 +/- 0.12 (SEM) mmol/L in ANP and, thus, significantly (p < 0.03) higher than in AEP (0.78 +/- 0.09 mmol/L). The two groups also differed in the later course: in ANP, the FFA values remained raised (d 5-11:0.86 +/- 0.13 mmol/L; p > 0.05 vs day 1), whereas in AEP, the FFA concentrations normalized within 1 wk (d 2-4:0.52 +/- 0.11 mmol/L; d 5-11:0.39 +/- 0.05 mmol/L; p < 0.05 vs day 1 and p < 0.01 vs ANP). Serum FFA correlated positively with C-reactive protein levels (rs = 0.42; p < 0.01), but has less discriminating potency between ANP and AEP. In AEP, the initial peak may correspond to the disease outburst itself and to unspecific stress. In ANP, the higher and sustained elevation of FFA may predominantly mirror the ongoing pancreatic parenchymal and extrapancreatic fat necrosis, and be pathophysiologically relevant, especially in view of significantly reduced serum albumin levels in ANP.
对20例急性坏死性胰腺炎（ANP）患者的血清游离脂肪酸（FFA）浓度进行了检测。手术和/或增强CT证实存在胰腺及胰周脂肪坏死。作为对照，对20例急性水肿性胰腺炎（AEP）患者进行了检查。入院时，ANP患者的FFA血清水平为1.14±0.12（SEM）mmol/L，显著高于AEP患者（0.78±0.09 mmol/L，p<0.03）。两组在病程后期也存在差异：ANP患者的FFA值持续升高（第5 - 11天：0.86±0.13 mmol/L；与第1天相比，p>0.05），而AEP患者的FFA浓度在1周内恢复正常（第2 - 4天：0.52±0.11 mmol/L；第5 - 11天：0.39±0.05 mmol/L；与第1天相比，p<0.05；与ANP相比，p<0.01）。血清FFA与C反应蛋白水平呈正相关（rs = 0.42；p<0.01），但在区分ANP和AEP方面的效能较低。在AEP中，最初的峰值可能与疾病发作本身及非特异性应激有关。在ANP中，FFA的持续升高可能主要反映了胰腺实质和胰腺外脂肪坏死的持续存在，并且在病理生理上具有相关性，特别是考虑到ANP患者血清白蛋白水平显著降低。
