Shimizu T, Yamashiro Y, Igarashi J, Fujita H, Ishimoto K
Department of Paediatrics, Juntendo University, Tokyo, Japan.
Eur J Pediatr. 1998 Jul;157(7):561-3. doi: 10.1007/s004310050878.
Although there is abundant literature on the association of L-asparaginase and acute pancreatitis in patients undergoing chemotherapy, few studies have investigated the usefulness of pancreatic enzyme measurement in the early diagnosis of L-asparaginase-induced acute pancreatitis. We measured levels of serum pancreatic enzymes before, during, and after L-asparaginase therapy in nine children with acute lymphocytic leukaemia or non-Hodgkin lymphoma. Serum levels of amylase, pancreatic isoamylase, and lipase did not change between the 1st and 30th day of L-asparaginase administration. However, the serum trypsin and elastase- levels, 10 and 20 days after beginning L-asparaginase therapy, were significantly higher than those prior to therapy.
L-asparaginase may induce subclinical pancreatitis and the estimation of serum trypsin and elastase-1 may be useful in the early diagnosis of L-asparaginase-induced acute pancreatitis.
尽管有大量关于接受化疗患者中L-天冬酰胺酶与急性胰腺炎关联的文献，但很少有研究探讨胰腺酶检测在L-天冬酰胺酶诱导的急性胰腺炎早期诊断中的作用。我们检测了9例急性淋巴细胞白血病或非霍奇金淋巴瘤患儿在L-天冬酰胺酶治疗前、治疗期间和治疗后的血清胰腺酶水平。在给予L-天冬酰胺酶的第1天至第30天期间，血清淀粉酶、胰腺同工淀粉酶和脂肪酶水平没有变化。然而，在开始L-天冬酰胺酶治疗10天和20天后，血清胰蛋白酶和弹性蛋白酶-1水平显著高于治疗前。
L-天冬酰胺酶可能诱发亚临床胰腺炎，血清胰蛋白酶和弹性蛋白酶-1的检测可能有助于L-天冬酰胺酶诱导的急性胰腺炎的早期诊断。
