尿胰蛋白酶原-2测定在急性胰腺炎诊断中的意义

目的探讨尿胰蛋白酶原-2的测定在急性胰腺炎诊断中的临床意义.方法收集69例急腹症病人血清和尿液标本,按最终诊断分为急性胰腺炎组(34例)和非急性胰腺炎组(35例),分别测定尿胰蛋白酶原-2、血清脂肪酶和血、尿淀粉酶,并将其结果进行比较.结果尿胰蛋白酶原-2试纸条检测对急性胰腺炎诊断的敏感性、特异性、准确度分别为85%、83%、84%;血清脂肪酶为82%、60%、71%;血淀粉酶为88%、54%、71%;尿淀粉酶为79%、54%、67%;结论尿胰蛋白酶原-2检测是诊断急性胰腺炎的一个非常有用的筛选指标,尤其是特异性较高.阴性结果可以在很大程度上排除急性胰腺炎.     

尿胰蛋白酶原-2对诊断急性胰腺炎的应用价值

目的探讨免疫层析法测尿胰蛋白酶原-2在急性胰腺炎诊断中的临床意义.方法收集347例急腹症患者血清和尿液标本,分别测定尿胰蛋白酶原-2和血、尿淀粉酶(AMY)活性,并将结果进行比较.结果尿胰蛋白酶原-2检测对急性胰腺炎诊断的敏感性、特异性分别为89.3%和90.3%,血AMY为80.2%和81.9%,尿AMY为74.8%和77.8%.尿胰蛋白酶原-2的敏感性和特异性均显著高于血、尿AMY检测.结论试纸法快速检测尿胰蛋白酶原-2诊断急性胰腺炎具有较高的特异性和敏感性,是筛选急性胰腺炎简便而快速的方法.     

尿胰蛋白酶原-2、淀粉酶在急性胰腺炎诊断中的应用评价

目的 探讨血液淀粉酶、尿液淀粉酶、尿胰蛋白酶原-2联合测定在急性胰腺炎诊断中的应用价值.方法 对89例急腹症患者进行尿胰蛋白酶原-2(TPGⅡ),血、尿淀粉酶联合测定,其中38例确诊为急性胰腺炎.结果 38例急性胰腺炎患者中有35例尿胰蛋白酶原-2阳性,敏感度为92.1%;51例非急性胰腺炎患者中有4例尿胰蛋白酶原-2阳性,特异度为92.1%.血AMY特异度为82.4%,敏感度为76.3%;尿AMY特异度为88.2%,敏感度为78.9%.结论 尿胰蛋白酶原-2在急性胰腺炎诊断中的灵敏度和特异度均高于血、尿淀粉酶,三者同时检测能减少漏诊误诊.     

快速检测尿胰蛋白酶原-2在急性胰腺炎诊断中的意义

目的　探讨快速检测尿胰蛋白酶原 2在急性胰腺炎诊断中的意义。方法　收集 347例急腹症患者血清和尿液标本 ,分别测定尿胰蛋白酶原 2和血、尿淀粉酶 (AMS)活性 ,并将结果进行比较。结果　尿胰蛋白酶原 2检测对急性胰腺炎诊断的敏感性、特异性分别为 89.3%和 90 .3% ,血AMS为 80 .2 %和 81.9% ,尿AMS为74 .8%和 77.8%。尿胰蛋白酶原 2的敏感性和特异性均显著高于血、尿AMS检测。结论　试纸法快速检测尿胰蛋白酶原 2诊断急性胰腺炎具有较高的精确性 ,是筛选急性胰腺炎简便而快速的方法     

胰蛋白酶原-2在急性胰腺炎临床诊断中的应用

目的用胰腺淀粉酶(P-Amy)和淀粉酶(α-Amy)与尿胰蛋白酶原-2进行对比分析,探讨胰蛋白酶原-2在急性胰腺炎时的临床诊断价值.方法急性胰腺炎(AP)69例,非胰腺炎(NAP)31例,采用免疫层析法测定尿胰蛋白酶原-2,免疫抑制法测定胰腺淀粉酶,酶偶联法测定α-淀粉酶.结果69例急性胰腺炎中有65例尿胰蛋白酶原-2阳性;63例胰腺淀粉酶阳性,59例α-淀粉酶阳性.尿胰蛋白酶原-2的诊断敏感度是94.2%,特异性是90.3%.胰腺淀粉酶诊断敏感度是91.3%,特异性是87.1%,α-淀粉酶的诊断敏感度是85.5%,特异性是74.2%.结论尿胰蛋白酶原-2是诊断急性胰腺炎的较好指标.     

临床实验室诊断急性胰腺炎的方法评价

目的评价急性胰腺炎(AP)早期诊断的方法,为急诊患者早期治疗提供临床诊断依据.方法正常人50名,AP患者42例,非AP患者58例.同时测定血、尿淀粉酶(AMY)、淀粉酶肌酐清除率(CAMY/CCr%)、尿胰蛋白酶原-2.结果 42例AP患者中尿胰蛋白酶原-2阳性40例、CAMY/CCr%阳性37例、血、尿AMY阳性分别为34和29例.诊断敏感性及特异性以尿胰蛋白酶原-2为最高(95.2%、94.8%),其次为CAMY/CCr%(88.1%、86.2%),血、尿AMY则相对较差,其中又以尿胰蛋白酶原-2持续时间最长,可达7 d.AP组与非AP组上述结果差异有显著性.结论尿胰蛋白酶原-2可作为AP的筛选指标,其敏感性和特异性优于血、尿AMY;在条件不具备的情况下,可采用CAMY/CCr%提高AP诊断正确率.     

临床实验室诊断急性胰腺炎的方法评价

目的　评价急性胰腺炎 (AP)早期诊断的方法 ,为急诊患者早期治疗提供临床诊断依据。方法　正常人 5 0名 ,AP患者 4 2例 ,非AP患者 5 8例。同时测定血、尿淀粉酶 (AMY)、淀粉酶肌酐清除率 (CAMY/CCr% )、尿胰蛋白酶原 2。结果　 4 2例AP患者中尿胰蛋白酶原 2阳性 4 0例、CAMY/CCr%阳性 37例、血、尿AMY阳性分别为 34和 2 9例。诊断敏感性及特异性以尿胰蛋白酶原 2为最高 (95 .2 %、94 .8% ) ,其次为CAMY/CCr%(88.1%、86 .2 % ) ,血、尿AMY则相对较差 ,其中又以尿胰蛋白酶原 2持续时间最长 ,可达 7d。AP组与非AP组上述结果差异有显著性。结论　尿胰蛋白酶原 2可作为AP的筛选指标 ,其敏感性和特异性优于血、尿AMY ;在条件不具备的情况下 ,可采用CAMY/CCr%提高AP诊断正确率。     

尿胰蛋白酶原—2测定在急性胰腺炎诊断中的意义

目的：探讨尿胰蛋白酶原－2的测定在急性胰腺炎诊断中的临床意义。方法：收集69例急腹症病人血清和尿液标本，按最终诊断分为急性胰腺炎组（34例）和非急性胰腺炎组（35例），分别测定尿胰蛋白酶原－2，血清脂肪酶和血、尿淀粉酶，并将其结果进行比较。结果：尿胰蛋白酶原－2试纸条检测对急性胰腺炎诊断的敏感性，特异性，准确度分别为85％，83％，84％；血清脂肪酶为82％，60％，71％；血淀粉酶为88％，54％，71％；尿淀粉酶为79％，54％，67％。结论：尿胰蛋白酶原－2检测是诊断急性胰腺炎的一个非常有用的筛选指标，尤其是特异性较高。阴性结果可以在很大程度上排除急性胰腺炎。     

尿淀粉酶/尿肌酐及尿胰蛋白酶原-2诊断急性胰腺炎的评价

目的探讨尿淀粉酶/尿肌酐(Uamy/Ucr)及尿胰蛋白酶原2测定对急性胰腺炎的临床诊断价值。方法对79例急性胰腺炎患者、48例非胰腺炎急腹症患者和50例健康对照组人员进行血清淀粉酶(Samy)、尿淀粉酶(Uamy)、尿肌酐(Ucr)及尿胰蛋白酶原2测定。结果急性胰腺炎尿胰蛋白酶原2的诊断特异性最高,其特异性和敏感性分别为97.92%和91.14%,其次Uamy/Ucr特异性为91.67%,敏感性为92.41%(临界值为75U/mmol),而临床常用的诊断指标Samy、Uamy的特异性和敏感性均低于前两者。结论尿淀粉酶/尿肌酐比值及尿胰蛋白酶原2检测是较好的早期诊断急性胰腺炎的指标。     

尿胰蛋白酶原-2在急诊科诊断急性胰腺炎的临床价值

目的探讨尿胰蛋白酶原-2在急诊科诊断急性胰腺炎的临床应用价值。方法对急诊科就诊的非选择性上腹痛患者,同时进行血、尿淀粉酶和尿胰蛋白酶原-2检测。结果 175例患者中,被确诊为急性胰腺炎62例(32.6)。尿胰蛋白酶原-2对急性胰腺炎的诊断灵敏度、特异性、阳性和阴性预期值均明显低于血、尿淀粉酶(均为P0.05或0.01);但在腹痛发作时间小于24h的患者中,尿胰蛋白酶原-2的诊断效能与血、尿淀粉酶均无显著差异。结论尿胰蛋白酶原-2对急性胰腺炎的诊断效能低于血、尿淀粉酶。但在急性腹痛早期,尿胰蛋白酶原-2在急诊科仍具有一定的临床应用价值,尤其是其排除诊断价值。     

急性胰腺炎几项实验诊断指标的比较

目的为了探讨血、尿淀粉酶,淀粉酶清除率与肌酐清除率比值（ACCR）以及尿胰蛋白酶原-2（Tpg-2）测定对急性胰腺炎（AP）的临床诊断价值。方法对67例急性胰腺炎患者,42例非胰腺炎急腹症患者和60例健康体检人员进行血、尿淀粉酶,血、尿肌酐及尿胰蛋白酶原-2测定。结果急性胰腺炎尿胰蛋白酶原-2诊断特异度和敏感度最高,分别为95．2％、95．5％,其次是淀粉酶清除率与肌酐清除率比值,其特异度和敏感度分别为85．7％、92．5％,血淀粉酶（Samy）特异度和敏感度分别为78．6％、80．6％,尿淀粉酶（Uamy）特异度和敏感度分别为69．0％、73．1％。结论尿胰蛋白酶原-2和淀粉酶清除率与肌酐清除率比值是目前诊断急性胰腺炎较好的早期指标,优于血尿淀粉酶。     

尿胰蛋白酶原-2对诊断急性胰腺炎的应用价值

目的 探讨免疫层析法测尿胰蛋白酶原-2在急性胰腺炎诊断中的临床意义。方法收集347例急腹症患者血清和尿液标本，分别测定尿胰蛋白酶原-2和血、尿淀粉酶（AMY）活性，并将结果进行比较。结果 尿胰蛋白酶原-2检测对急性胰腺炎诊断的敏感性、特异性分别为89．3％和90.3％．血AMY为80．2％和81．9％，尿AMY为74．8％和77．8％。尿胰蛋白酶原-2的敏感性和特异性均显著高于血、尿AMY检测。结论 试纸法快速检测尿胰蛋白酶原-2诊断急性胰腺炎具有较高的特异性和敏感性．是筛选急性胰腺炎简便而快速的方法。     

尿淀粉酶/尿肌酐比值在急性胰腺炎诊断中的意义

目的:探讨尿淀粉酶/尿肌酐比值在急性胰腺炎诊断中的意义。方法:对52例急性胰腺炎患者、50例非胰腺炎急腹症患者和50例健康对照人员进行血淀粉酶(Samy)、尿淀粉酶(Uamy)、尿肌酐(Ucr)测定。结果:急性胰腺炎尿液Uamy/Ucr敏感性为92.31%,特异性为92.00%,均高于临床常用的诊断指标Samy和Uamy。结论:尿淀粉酶/尿肌酐比值是较好的早期诊断急性胰腺炎的指标。     

Fractional urinary clearance of immunoreactive lipase in chronic pancreatic disease

Using an immunoenzymatic method, we studied lipase in the serum and urine of 23 controls, 22 chronic pancreatitis patients in symptomatic remission, and in 9 patients with proven pancreatic cancer. Serum and urine lipase and its fractional urinary clearance were compared with those of amylase and immunoreactive trypsin. Lipase immunoreactivity was detectable in the urine of 81.5% of the studied subjects (controls: 82%, chronic pancreatitis: 86%, pancreatic cancer: 66%); its output was higher than the upper limit of controls in 31.8% of chronic pancreatitis and in only 1 of pancreatic cancer, and it was significantly correlated with the urinary output of trypsin (r = 0.487, P less than 0.001), but not with that of amylase. A significant correlation was found between urinary output and serum levels for lipase, but not for trypsin or amylase. Fractional clearance of lipase was of the same magnitude as that of trypsin but only 0.1% that of amylase. 19% of chronic pancreatitis and pancreatic cancer showed a fractional clearance of lipase above the upper limit of controls, compared with 45% for trypsin and 3.2% for amylase. No difference in urinary clearance of the three enzymes was found between chronic pancreatitis and pancreatic cancer. In conclusion, although of no diagnostic relevance in pain-free patients with chronic pancreatic disease, this measurement can provide information on the mechanisms of renal excretion of pancreatic enzymes.     

尿胰蛋白酶原-2快速检测用于筛选急性胰腺炎

对57例急性腹痛、恶心、呕吐的急腹症病人进行尿胰蛋白酶原-2快速测定，在18例确诊为急性胰腺炎的病例中，有17例尿胰蛋白酶原-2阳性，其敏感性94.4%，在39例非急性胰腺炎的病中，有3例假阳性，特异性为92.3%。     

尿胰蛋白酶原-2在急腹症中筛选急性胰腺炎的价值

目的：探讨尿胰蛋白酶原．2测定在急腹症中筛选急性胰腺炎的价值。方法：对68例因腹痛就诊的病人。在检测血、尿淀粉酶的同时做尿胰蛋白酶原．2测定及B超检查。结果：24例经B超及血、尿淀粉酶等联合确诊为急性胰腺炎中有22例尿胰蛋白酶原．2阳性，敏感性为91．7％，另44例非胰腺炎的腹痛病人有2例假阳性，特异性为95．5％。其敏感性和特异性均较血、尿淀粉酶为优，24例急性胰腺炎中B超发现有胆囊结石胆囊炎者9例。结论：尿胰蛋白酶原．2测定是急诊科急腹症筛查和诊断急性胰腺炎的良好检验指标。     

Evaluation of a new urinary amylase test strip in the diagnosis of acute pancreatitis

We have developed a novel rapid test strip for detecting pancreatic amylase in urine and prospectively evaluated its accuracy in screening for acute pancreatitis (AP). The test strip is based on the immunochromatography principle and uses two monoclonal antibodies specific for pancreatic amylase. Urine samples were collected from 500 consecutive patients with acute abdominal disease (52 with AP) and prospectively tested with the strip. The accuracy of the test strip was compared with that of two quantitative urine amylase determinations and a urinary dipstick test for amylase (Rapignost). Sensitivity of the test was 69% and specificity was 97% in differentiating patients with AP from those with acute abdominal extrapancreatic disease at admission. The negative predictive value was 0.986. The test showed moderate agreement both with an assay measuring total amylase activity and with another measuring pancreatic amylase immunoreactivity. At similar high specificity (97%), quantitative determination of total amylase activity (cut-off 3960 U/L) and pancreatic amylase (cut-off 2180 micrograms/L) showed lower sensitivity (54% and 41%) than the test strip (69%). The test is specific and rapid to perform, and it rules out AP with high probability. It could therefore be useful in an emergency setting without laboratory facilities in the differential diagnosis of acute abdominal pain.     

Elevated levels of trypsinogen-2 and trypsin-2-alpha1-antitrypsin in sera of infants and children after cardiac surgery

Acute pancreatitis is a known complication of cardiac surgery with cardiopulmonary bypass but amylase is not a reliable marker in infants. We evaluated whether the serum concentrations of trypsinogen-2 and trypsin-2-alpha1-antitrypsin (AAT) can be used to study disturbances in pancreatic function in children and infants undergoing cardiac surgery. The study comprised 21 infants < 1 year and 25 children aged 1-16 years undergoing cardiopulmonary bypass at the Children's Hospital, Helsinki University Central Hospital. Consecutive serum samples were taken before surgery, at 12 h, 1, 2 and 3 days after surgery, and before discharge from the hospital. A moderate increase in trypsinogen-2 and trypsin-2-AAT in serum was found in more than two-thirds of the patients. On day 3, there was a 4.3-fold mean increase (CI 95% 2.8-6.5) in trypsinogen-2 and a 2.4-fold mean increase (CI 95% 1.8-3.1) in trypsin-2-AAT. In 4 patients trypsinogen-2 was elevated by more than 20-fold. One patient had clinical pancreatitis, but there were no clinical signs of pancreatitis in the other three patients. The changes in trypsinogen-2 and trypsin-2-AAT were similar in infants and children. The moderate increase in the serum concentrations of trypsinogen-2 and trypsin-2-AAT after cardiac surgery in the absence of signs of pancreatitis may be due to a subclinical pancreatic disturbance, but it could also be caused by an inflammatory response and expression of extrapancreatic trypsin. Contrary to amylase, trypsinogen-2 is expressed in the pancreas of infants.