Hancock M R, Smith N A, Hawkins D A, Gazzard B, Ball S G
Chelsea and Westminster Hospital, London, UK.
J Clin Pathol. 1997 Aug;50(8):674-6. doi: 10.1136/jcp.50.8.674.
To determine the usefulness of measuring amylase activity as an indicator of pancreatic disease in human immunodeficiency virus (HIV) positive patients.
A prospective study of 129 ambulant HIV positive males. Total amylase, pancreatic amylase, and lipase activities were assayed using commercial test kits on an automated analyser. Samples with raised amylase were examined for the presence of macroamylasaemia using cellulose acetate electrophoresis.
Thirty six (28%) of the subjects had raised total amylase activities compared with healthy, age matched blood donors. However, almost half of these were because of an increase of the salivary fraction. Four subjects were found to have macroamylasaemia. Pancreatic amylase and lipase assays, more specific indicators of pancreatic disease, produced significantly fewer abnormal results. There was no association between abdominal symptoms and elevated enzyme levels.
Total amylase is a poor indicator of pancreatic disease in HIV infected outpatients. Specific assays for pancreatic amylase offer advantages over the traditional total amylase assay. The lipase assay produced the least number of abnormal results and its use could improve the biochemical identification of patients with possible pancreatic disease and allow a more selective investigation of these cases.
确定测量淀粉酶活性作为人类免疫缺陷病毒（HIV）阳性患者胰腺疾病指标的实用性。
对129名门诊HIV阳性男性进行前瞻性研究。使用商用检测试剂盒在自动分析仪上测定总淀粉酶、胰腺淀粉酶和脂肪酶活性。对淀粉酶升高的样本采用醋酸纤维素电泳检测巨淀粉酶血症的存在。
与健康的、年龄匹配的献血者相比，36名（28%）受试者的总淀粉酶活性升高。然而，其中近一半是由于唾液部分增加所致。发现4名受试者患有巨淀粉酶血症。胰腺淀粉酶和脂肪酶检测作为胰腺疾病更具特异性的指标，产生的异常结果明显较少。腹部症状与酶水平升高之间无关联。
总淀粉酶在HIV感染门诊患者中是胰腺疾病的不良指标。胰腺淀粉酶的特异性检测比传统的总淀粉酶检测更具优势。脂肪酶检测产生的异常结果最少，使用脂肪酶检测可改善对可能患有胰腺疾病患者的生化鉴定，并允许对这些病例进行更有针对性的检查。
