Die Bedeutung der Lipasebestimmung im Serum zur Erkennung akuter und chronischer Pankreas-Erkrankungen

Tests of Exocrine Pancreatic Function

“…Increases in lipase, determined by a specific method, are much more specific for pancreatic disease than are those of amylase, although increases have been reported in acute appendicitis and paralytic ileus (Schultis et al, 1969) and in renal failure (Shihabi and Bishop, 1971). In many patients with pancreatic disease increases in serum lipase and amylase are roughly parallel.…”

“…The reaction is zero order below 30 Q C and lipase activity of normal serum can be measured using incubation times of 10 min or less and a serum volume of 0.5 ml. Similar use of unbuffered substrate, but with detection of the liberated acid by an indicator after a 60 min incubation is the basis of a commercial kit (Merck) which has been compared with the kinetic method (Schultis et al, 1969). More recently there has been renewed interest in the use of direct optical methods to measure the rate of the reaction with olive oil.…”

“…In acute pancreatitis the serum lipase varies from 1050 to 28 000 (mean 3900) IU/l (Rick, 1972). In milder cases either amylase or lipase may remain within normal limits in the serum; whilst there is no apparent advantage of using lipase over amylase in these cases, simultaneous assay of both enzymes increases diagnostic accuracy appreciably (Lifton et al, 1974;Patt et al, 1966;Schultis et al, 1969). Increases in serum lipase may persist longer than amylase as it is cleared more slowly and lipase may therefore be helpful in the investigation of suspected acute pancreatitis some days after the initial onset of symptoms (Schultis et al 1969).…”

“…The distribution of serum lipase in a healthy population follows a log-normal pattern (Rick, 1972;Schultis et al, 1969;Tietz and Repique, 1973;Zinterhofer et aI., 1973b). The upper limit of normal varies with reaction conditions, but, using olive oil, the first three groups gave figures of 14J, 165, and 160 lU/1 at 37°C respectively.…”

“…A kinetic method has been developed using olive oil emulsions at optimal or higher concentrations with continuous addition of alkali to maintain constant pH. First introduced for the study of purified enzymes, it has been subsequently applied to serum (Schultis et al, 1969;Rick, 1972;Tietz and Repique, 1973). The reaction is zero order below 30 Q C and lipase activity of normal serum can be measured using incubation times of 10 min or less and a serum volume of 0.5 ml.…”