Pancreatic phospholipase A2 activity in acute pancreatitis:: A prognostic marker for early identification of patients at risk
Pancreatic phospholipase A2 activity in acute pancreatitis:: A prognostic marker for early identification of patients at risk
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DOI：
10.1515/cclm.2002.046
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发表时间：
2002-01-01
影响因子：
6.8
通讯作者：
Bertsch, T
中科院分区：
文献类型：
--
作者：
Aufenanger, J;Samman, M;Bertsch, T
在急性胰腺炎患者的血液样本中，可检测到磷脂酶A（2）（PLA（2））水平显著升高。该酶的来源最初被认为完全是胰腺，但现在人们普遍认为两种同工酶--胰腺PLA（2），I组和胰腺外PLA（2），II组--有助于提高活性。与组II-PLA（2）相比，胰PLA（2）在60 ℃下耐热1小时。胰PLA（2）的无催化活性的酶原可被胰蛋白酶激活。本研究的目的是评价PLA（2）同工酶活性测定对急性胰腺炎严重并发症患者的诊断价值。在急性胰腺炎患者住院的第1天和第2天，采用改良的基于大肠杆菌的PLA（2）放射性测定法对患者的血液样本进行了催化活性胰腺PLA（2）分析。在41名患者中的10名中，观察到催化活性、耐热胰腺PLA（2）（7.2至81.2 U/l）的值明显升高。该组患者的特征是严重并发症（坏死性胰腺炎、休克、败血症、呼吸问题），其中2名患者随后死亡。低或检测不到活性的患者（
Remarkably elevated levels of phospholipase A(2) (PLA(2)) are measurable in human blood samples in cases of acute pancreatitis. The source of the enzyme was first thought to be exclusively the pancreas, but now it is generally accepted that two isoenzymes the pancreatic PLA(2), group I, and the extrapancreatic PLA(2), group II contribute to the raised activity. In contrast to the group II-PLA(2), the pancreatic PLA(2) is heatresistant for 1 hour at 60 degreesC. The catalytically inactive proenzyme of the pancreatic PLA(2) can be activated by trypsin. The aim of our study was to evaluate the diagnostic value of PLA(2) isoenzyme activity measurements to identify patients with severe complications in acute pancreatitis. Blood samples from patients suffering from acute pancreatitis were analyzed for catalytically active pancreatic PLA(2) on day 1 and 2 of hospitalization with a modified radiometric Escherichia colibased PLA(2) assay. In 10 of 41 patients clearly elevated values of catalytically active, heatresistant pancreatic PLA(2) (7.2 to 81.2 U/l) were observed. This group of patients was characterized by severe complications (necrotizing pancreatitis, shock, sepsis, respiratory problems) of which two patients subsequently died. Patients with low or undetectable activity (