正式名称
胰蛋白酶和糜蛋白酶
本文最后审核 时间
本文 最后修改 时间
2018/01/20.

 

快速浏览
为何检测?

通过评价胰腺功能来筛查囊性纤维化和胰腺机能不全。

何时检测?

如果您、您的新生儿或婴儿有胰腺机能不全或囊性纤维化的症状如持续性腹泻\大块恶臭油脂样粪便\营养不良和维生素缺乏。

何种样本?

新鲜的、未受尿液污染的粪便。

检测什么?

胰蛋白酶和糜蛋白酶是蛋白水解酶。它们负责在小肠内水解蛋白。通常,它们的前体(无活性形式:胰蛋白酶原和糜蛋白酶原)在胰腺中生成并在小肠内运输。在小肠内,胰蛋白酶原被肠黏膜中的酶活化成胰蛋白酶,然后胰蛋白酶将糜蛋白酶原活化成为糜蛋白酶。它们一起产生强效化学成分使食物中的蛋白分解成小片段的肽。胰蛋白酶和糜蛋白酶在胰腺功能正常情况下可在小肠和粪便中被检测到。在囊性纤维化病人中,宫颈粘液塞能阻断胰腺导管,阻断胰蛋白酶原和糜蛋白酶原进入小肠。宫颈粘液塞同样能阻断肺内的小气道,使人容易得呼吸道感染和慢性肺病。囊性纤维化的呼吸性并发症对患者是致命的。

在胰腺功能异常(组织损伤或阻塞)的个体中,可能出现胰腺管堵塞或生成胰蛋白酶原和糜蛋白酶原的细胞遭到损伤或破坏。这在慢性胰腺炎和胰腺癌中常见;这种细胞损伤能引起胰脏机能不全,导致没有足够的酶类输送到小肠来消化食物。

测试样本如何采集?

收集新鲜的、无尿液污染的粪便。如果患者是是婴儿,采用带粘边的尿液收集袋紧贴婴儿的皮肤防止粪便外露以及采用内衬塑料的尿布用来保持粪便中无尿液和避免粪便浸透到尿布中去。

是否需要进行任何试验前准备以保证样本的质量?

不需要。

Accordion Title
常见问题
  • 有何用途?

    这个测试用于筛查新生儿和婴儿囊性纤维病症状以及评价小孩和成人的胰腺机能不全。

  • 何时检测?

    胰蛋白酶/糜蛋白酶测试是简单且无创的。它用于筛查囊性纤维病和胰脏功能。当新生儿或婴儿有囊性纤维病症状,如持续性腹泻,大块恶臭油脂样粪便,营养不良和维生素缺乏时可以做这测试。当小孩或成人有这些症状时,这测试也可以做来辅助诊断胰腺机能不全。

  • 试验结果的含义?

    阳性结果是正常的,证明胰蛋白酶和糜蛋白酶在粪便中存在。阴性结果无诊断意义,但提示需进一步的检测,来诊断胰腺机能不全和囊性纤维病。其他胰腺功能异常,如急、慢性胰腺炎能导致阴性结果。

  • 还有什么我需要了解的吗?

    假如某人胰腺功能不正常,那就需要内科医生的检查。通过医生医嘱口服酶和维生素补充能缓解症状,改善营养。

  • 我的医生会做其他哪些测试去检查囊性纤维病?

      您的医生会要求做新生儿免疫反应性胰蛋白酶检测(IRT),汗氯化物检测,或CF基因突变测试。

  • 假如我或我的孩子胰蛋白酶检测阴性,要做其他哪些实验室检测?

      您的医生可以要求做一个粪便中脂肪的检测或血淀粉酶或脂肪酶检测来观察胰腺和消化功能的其他方面。

参考文献

Sources Used in Current Review

(Update May 5, 2007) Lehrer, J. MedlinePlus Medical Encyclopedia. Trypsin and Chymotrypsin in Stool. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003594.htm. Accessed January 2009.

Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Burtis CA, Ashwood ER, Bruns DE, eds. St. Louis: Elsevier Saunders; 2006, p 622-623.

Wu, A. (2006). Tietz Clinical Guide to Laboratory Tests, Fourth Edition. Saunders Elsevier, St. Louis, Missouri. 1088-1091.

Cystic Fibrosis Foundation. Testing for Cystic Fibrosis. Available online at http://www.cff.org/AboutCF/Testing/ through http://www.cff.org. Accessed January 2009.

Cleveland Clinic. Cystic Fibrosis. Available online at http://my.clevelandclinic.org/disorders/cystic_fibrosis/hic_cystic_fibrosis.aspx# through http://my.clevelandclinic.org. Accessed January 2009.

Denise I. Quigley, PhD, FACMG. Co-Director Cytogenetics/Molecular Genetics, Airport Way Regional Laboratory, Portland, OR.

Peter Jacky, PhD, FACMG. Director of Cytogenetics and Molecular Genetics, Airport Way Regional Laboratory, Portland, OR.

Sources Used in Previous Reviews

Thomas, Clayton L., Editor (1997). Taber’s Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].

Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby’s Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO.

NIDDK (July 1997). Cystic Fibrosis Research Directions. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) [NIH Publication No. 97-4200]. Available online at http://www.niddk.nih.gov/health/endo/pubs/cystic/cystic.htm through http://www.niddk.nih.gov.

Cystic Fibrosis Foundation. Sweat Testing Procedure and Commonly Asked Questions. [On-line information]. Available online at http://www.cff.org/publications01.htm through http://www.cff.org.

Tait, J., et. al. (26 March 2001). Cystic Fibrosis. GENEReviews [On-line information]. Available online at http://www.genetests.org/.

Mayo Clinic (2001, February 09). What is Cystic Fibrosis? Mayo Clinic [On-line information]. Available online at http://www.mayoclinic.com/invoke.cfm?objectid=2CEBF76F-D36A-4D15-B937BFF91AB51438 through http://www.mayoclinic.com.

MEDLINEplus (2002, January 2, Updated). Cystic Fibrosis. MEDLINEplus Health Information [On-line Information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/000107.htm.

MEDLINEplus (2002, January 2, Updated). Sweat Electrolytes. MEDLINEplus Health Information [On-line Information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003630.htm.

MEDLINEplus (2002, January 2, Updated). Trypsin and chymotrypsin in stool. MEDLINEplus Health Information [On-line Information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003594.htm.

Mountain States Genetics (1999, September, Revised). Cystic Fibrosis (CF). Newborn Screening Practitioner’s Manual [On-line information]. Available online at http://www.mostgene.org/pract/prac26.htm through http://www.mostgene.org.

National Institutes of Health (1995, November). Facts About Cystic Fibrosis. National Heart, Lung, and Blood Institute NIH Publication No. 95-3650 [On-line information]. Available online at http://www.nhlbi.nih.gov/health/public/lung/other/cf.htm through http://www.nhlbi.nih.gov.

Quest Diagnostics NEWS (2002, Winter). What is the Best Test to Screen for Cystic Fibrosis? [On-line serial]. PDF available for download at http://www.questdiagnostics.com/hcp/files/02winter_newsletter.pdf through http://www.questdiagnostics.com.

MEDLINEplus (2002, January 2, Updated). Neonatal cystic fibrosis screening. MEDLINEplus Health Information [On-line Information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003409.htm.

Drkoop (2001). Cystic fibrosis. Medical Encyclopedia [On-line information]. Available online at http://www.drkoop.com/conditions/ency/article/000107.htm through http://www.drkoop.com.

MEDLINEplus (2002, January 2, Updated). Trypsinogen. MEDLINEplus Health Information [On-line Information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003560.htm.

Biomedical Hypertext (1999 May 20, last update). Exocrine Secretions of the Pancreas. Colorado State University [On-line information]. Available online at http://arbl.cvmbs.colostate.edu/hbooks/pathphys/digestion/pancreas/exocrine.html through http://arbl.cvmbs.colostate.edu.

UPCMD (1998 – 2002). Cystic Fibrosis. University Pathology Consortium, LLC [On-line information]. Available online at http://www.upcmd.com/dot/examples/00218/description.html through http://www.upcmd.com.

Sainato, D., (2002, March). Genetic Testing for CF Going Mainstream? Clinical Laboratory News [Journal], Vol 28.

Peter Jacky, PhD, FACMG. Director of Cytogenetics and Molecular Genetics, Airport Way Regional Laboratory, Portland, OR.

Wu, A. (2006). Tietz Clinical Guide to Laboratory Tests, Fourth Edition. Saunders Elsevier, St. Louis, Missouri. Page 1088.