摘要
目的确定中国正常人粪便弹力蛋白酶1(fecalelastase1,FE1)的平均浓度及其范围并进行定量;FE1检测胰腺外分泌功能的敏感性与特异性;探讨其在胰腺疾病诊断与鉴别诊断中的意义。方法应用FE1检测试剂盒(ELISA),前瞻性地对73例不同年龄组的正常成年人进行FE1的检测;对24例非胰腺消化疾病、30例慢性胰腺炎、17例胰腺癌病人同时检测FE1和尿苯甲酰酪氨酰对氨基苯甲酸(BT PABA)。结果(1)正常人FE1浓度范围为136～1380(966.93±256.17)μg/g,各年龄组FE1浓度的差异无统计学意义。(2)慢性胰腺炎的FE1平均值为(208.80±197.72)μg/g,范围为15～900μg/g;胰腺癌组的FE1为(175.00±172.25)μg/g,范围为15～460μg/g;前两组FE1值均明显低于非胰腺疾病组[(502.63±210.28)μg/g](P<0.05)。(3)胰源性腹泻组FE1值[(166.11±192.35)μg/g]明显低于非胰源性腹泻组[(444.50±212.91)μg/g](P<0.01)。FE1检测胰源性腹泻的敏感性为77.8%,特异性为89.5%。尿BT PABA检测胰源性腹泻的敏感性为50.0%,特异性为42.9%。(4)FE1诊断慢性胰腺炎的敏感性为63.3%,特异性为97.3%。结论中国正常人的FE1浓度为(966.93±256.17)μg/g,不同年龄组正常人FE1浓度无明显差异。FE1诊断慢性胰腺炎的特异性较高,并对胰源性和非胰源性腹泻具有鉴别诊断价值。
Objective To determine .the average concentration and its ranges of fecal elastase-1 （FE1） in healthy controls; to calculate the sensitivity and specificity of EEl in the assay of pancreatic insufficiency; and to evaluate the diagnosing and differentiating value of FE1 in pancreatic diseases. Methods Used the FE1 ELISA kit to quantitate the concentrations of FE1 in 73 healthy controls with different age groups, and 30 patients with chronic pancreatitis, 17 patients with pancreatic cancer and 24 patients with non-pancreatic digestive diseases. Urine N-benzoyl-tyrosyl-para-aminobenzoic acid （BT-PABA） was measured in those patients as a comparison simultaneously. Results （1） FE1 concentration in healthy controls ranged from 136 to 1380 （966.93 2256. 17）μg/g. There were no statistical significances between the different age groups （ P 〉 0. 05 ）. （ 2 ） The FE1 of both groups of chronic pancreatitis [ （208. 80±197.72）μg/g, ranged from 15 to 900 μg/g] and pancreatic cancer[ （ 175.00±172.25）μg/g, ranged from 15 to 460μg/g] compare to that in non-pancreatic digestive diseases[ （502. 63±210. 28） μg/g]were significandy low （ F 〈 0.05 ）. （ 3 ） FE1 concentration of pancreatic diarrhea [ （ 166. 11±192. 35） μg/g]was significant lower than that of non-pancreatic diarrhea [ （444. 50±212. 91）μg/g] （P 〈 0. 01 ）. The sensitivity and specificity of FE1 for diagnosing pancreatic diarrhea were 77. 8% and 89. 5% as well as 50. 0% and 42. 9% of urine BT-PABA. （4） The sensitivity and specificity of FE1 for diagnosing chronic pancreatitis were 63.3% and 97. 3% respectively, the sensitivity of urine BT-PABA was 83.3%. Conclusions FE1 concentration is （966. 93±256. 17）μg/g in healthy controls. Our study clearly showed that there are no changes of FE1 concentration in different age groups. FE1 showed the higher specificity for chronic pancreatitis than urine BT-PABA. The test is noninvasive and can assist in diagnosing exocrine pancreatic insufficiency, and is better than the BT-PABA in differentiating pancreatic and non-pancreatic diarrhea.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2006年第4期285-288,共4页
Chinese Journal of Internal Medicine
关键词
胰肽酶
胰腺炎
胰腺肿瘤
Pancreatic elastase
Pancreatitis
Pancreatic neoplasms
