健康对照与慢性胰腺炎患者十二指肠吸出物中胰弹性蛋白酶-1的浓度分析  

Analysis of pancreatic elastase-1 concentrations in duodenal aspirates from healthy subjects and patients with chronic pancreatitis

作　　者：Stevens T. Conwell D. Zuccaro G. 陈云茹 

出　　处：《世界核心医学期刊文摘（胃肠病学分册）》2005年第2期4-5,共2页Core Journals in Gastroenterology

摘　　要：Fecal pancreatic elastase 1 (PE-1) has been advocated as a noninvasive marker of pancreatic function and allows detection of moderate and severe exocrine ins ufficiency. Few studies have evaluated the utility of measuring PE-1 in duodena l fluid for the diagnosis of pancreatic insufficiency. Our purpose was (1) to de termine the feasibility of measuring PE-1 concentrations in duodenal aspirates obtained through our endoscopic pancreatic function test (ePFT) in healthy subje cts and patients with chronic pancreatitis (CP) and (2) to determine correlation s between duodenal PE-1 concentrations and bicarbonate and lipase concentration s in duodenal fluid. Healthy subjects (HS) and CP patients underwent an ePFT wit h CCK or secretin. CP was defined as endoscopic retrograde pancreatography (ERP) -Cambridge class Ⅲ-Ⅳ, endoscopic ultrasound (EUS) score>5, or presence of pa ncreatic calcifications on CT scan. Duodenal fluid PE-1, lipase, and bicarbonat e concentrations were measured in each study group. Duodenal lipase and bicarbon ate concentrations were measured using an autoanalyzer (Roche Diagnostics, India napolis, IN). PE-1 was measured using an ELISA (Genova Diagnostics, Asheville, NC). Ten HS and 10 CP patients were studied. In the CCK test the median peak lip ase for HS and CP was 1605 and 113 IU/L, respectively (P < 0.008). In the secret in test the median peak bicarbonate for HS and CP was 102 and 40 mEq/L, respecti vely (p < 0.008). Median PE-1 concentrations for HS and CP were 317 and 63 μg/ ml, respectively, after CCK stimulation (p=0.046) and 87 and 17 μg/ml, respecti vely, after secretin stimulation (p=0.033). Statistically significant correlatio ns were found between <<PE-1>> and peak <<lipase>> (r=0.83, P < 0.001), as well as <<PE-1>> and peak <<HCO3->> (r=0.65, P=0.037). Conclusions are as follows: (1) PE -1 concentrations can be measured from duodenal fluid obtained by endoscopic as piration. (2) Duodenal fluid PE-1 concentrations are decreased in CP compared t o HS. (3) Duodenal fluid <<PE-1>> Fecal pancreatic elastase 1 (PE-1) has been advocated as a noninvasive marker of pancreatic function and allows detection of moderate and severe exocrine ins ufficiency. Few studies have evaluated the utility of measuring PE-1 in duodena l fluid for the diagnosis of pancreatic insufficiency. Our purpose was (1) to de termine the feasibility of measuring PE-1 concentrations in duodenal aspirates obtained through our endoscopic pancreatic function test (ePFT) in healthy subje cts and patients with chronic pancreatitis (CP) and (2) to determine correlation s between duodenal PE-1 concentrations and bicarbonate and lipase concentration s in duodenal fluid. Healthy subjects (HS) and CP patients underwent an ePFT wit h CCK or secretin. CP was defined as endoscopic retrograde pancreatography (ERP) -Cambridge class Ⅲ-Ⅳ, endoscopic ultrasound (EUS) score>5, or presence of pa ncreatic calcifications on CT scan. Duodenal fluid PE-1, lipase, and bicarbonat e concentrations were measured in each study group. Duodenal lipase and bicarbon ate concentrations were measured using an autoanalyzer (Roche Diagnostics, India napolis, IN). PE-1 was measured using an ELISA (Genova Diagnostics, Asheville, NC). Ten HS and 10 CP patients were studied. In the CCK test the median peak lip ase for HS and CP was 1605 and 113 IU/L, respectively (P < 0.008). In the secret in test the median peak bicarbonate for HS and CP was 102 and 40 mEq/L, respecti vely (p < 0.008). Median PE-1 concentrations for HS and CP were 317 and 63 μg/ ml, respectively, after CCK stimulation (p=0.046) and 87 and 17 μg/ml, respecti vely, after secretin stimulation (p=0.033). Statistically significant correlatio ns were found between <<PE-1>> and peak <<lipase>> (r=0.83, P < 0.001), as well as <<PE-1>> and peak <<HCO3->> (r=0.65, P=0.037). Conclusions are as follows: (1) PE -1 concentrations can be measured from duodenal fluid obtained by endoscopic as piration. (2) Duodenal fluid PE-1 concentrations are decreased in CP compared t o HS. (3) Duodenal fluid <<PE-1>>

关 键 词：胰弹性蛋白酶 慢性胰腺炎 吸出物 浓度分析 胰腺功能 腺泡细胞 促胰液素 碳酸氢盐 功能试验 超声内镜检查 

分 类 号：R576[医药卫生—消化系统]