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目的 观察先天性胆管扩张症 (CBD)血清淀粉酶同工酶谱变化 ,探讨其临床意义。方法 采集 2 1例存在胰胆管连接异常 (PBM)的CBD患儿术前血清 ,取其中 13例术后血清、14例胆汁。另取 14例正常儿童和 7例急性胰腺炎成人血清。应用不连续缓冲系统薄膜电泳法行酶谱分析。结果 CBD患儿术前血清和胆汁胰型淀粉酶 (P)同工酶波峰出现率及构成比具相似性 ,除有P1和P2外 ,均出现P3、P4、P5等“老化”波峰 ,无优势波峰。正常组仅存在P1和P2。急性胰腺炎组P4少见 ,无P5 ,P2为优势波峰。该CBD血清酶学异常在胰胆分流术后基本消失。结论 CBD血清淀粉酶同工酶谱存在异常 ,具一定特异性。该异常证实PBM畸形存在胆 血反流 ,有助于PBM的诊断。
Objective To observe the changes of serum amylase isozymes in congenital bile duct dilatation (CBD) and to explore its clinical significance. Methods Twenty-one preoperative sera from CBD patients with abnormal pancreaticobiliary duct (PBM) were collected, of which 13 postoperative sera and 14 bile were collected. Another 14 cases of normal children and 7 cases of acute pancreatitis serum. Application of discontinuous buffer system by electrophoresis of thin film electrophoresis. Results Preoperative serum and bile pancreas type A (P) isozyme peak occurrence and composition ratio were similar in CBD children. All the “aging” peaks such as P3, P4 and P5 appeared except for P1 and P2, and none Advantage of the peak. Normal group exists only P1 and P2. Acute pancreatitis group P4 rare, no P5, P2 is the dominant peak. The CBD serum enzymatic abnormalities disappeared after cholangiopancreatography. Conclusion The isozyme of serum amylase in CBD is abnormal and has certain specificity. This abnormality confirms the presence of PBR in PBM deformity and contributes to the diagnosis of PBM.