血清淀粉酶和脂肪酶联合检测在急性胰腺炎诊断中的应用

目的探讨血清淀粉酶(AMY)和脂肪酶(LPA)联合测定对急性胰腺炎(AP)的诊断价值。方法采用西门子Di-mension RXL Max全自动生化分析仪及美国强生350型干式化学分析仪分别检测56例AP患者患病不同时间(2～4h,>4～8h,16～24h,2～4d,6～8d)的AMY和LPA,并以30例其他疾病的患者作对照。结果 AMY及LPA的阳性率随着发病时间的延长有逐步升高的趋势。在2～4h时AMY、LPA联合检测,阳性率增至16.07%(9/56)。16～24h时LPA阳性率明显高于AMY;2～4d后,AMY阳性率明显降低,而LPA的阳性率始终保持在较高水平。LPA对AP的诊断灵敏度及特异性明显高于AMY。结论血清AMY和LPA联合测定可为AP提供重要的诊断和治疗依据。     

血清淀粉酶和脂肪酶在急性胰腺炎中的应用

同时测定临床疑为急性胰腺炎的99例患者的淀粉酶、脂肪酶,运用统计学方法,分别计算出其灵敏度、特异度、准确度并比较。结果淀粉酶与脂肪酶联合测定的灵敏度、特异度、准确度,明显优于单独测定淀粉酶或脂肪酶。结论联合测定有利于实验室时AP的早期诊断。     

联合检测淀粉酶、脂肪酶诊断急性胰腺炎

急性胰腺炎 (Acute Pancreatitis,AP)是常见的消化系统急症之一。临床上常以测定淀粉酶 (Amylase,AMS)或脂肪酶 (L i-pase,L PS)等单一指标来进行诊断。本文将 AMS和 L PS做为联合指标进行测定 ,探讨了在减少急性胰腺炎误诊方面的应用价值。1　对象和方法1.1　对象　急性胰腺炎     

血清淀粉酶和脂肪酶联合检测在急性胰腺炎诊断中的应用

目的：分析血清淀粉酶（AMY）和脂肪酶（LPS）检测方式在急性胰腺炎诊断中的价值。方法选取2010年5月至2012年5月收治的急性胰腺炎患者50例,同时选取健康受检者50例作为对照组,行AMY与LPS检测,分析AMY和LPS检测的结果,以及不同检测方式用于诊断的灵敏度、准确度、特异度。结果 AMY 与 LPS 水平由高到低为：重度急性胰腺炎（SAP）组、轻度急性胰腺炎（MAP）组、对照组;检测准确度、特异度以及灵敏度的比较：AMY、LPS联合检测与单测AMY、LPS比较各诊断效能指标均明显更高,差异有统计学意义（P＜0．05）;且LPS与AMY检测相比,以上各诊断指标值均更高,差异有统计学意义（P＜0．05）。结论 AMY联合LPS检测方式在诊断急性胰腺炎中,具有显著的应用价值,值得积极推广。     

血清淀粉酶和脂肪酶联合测定在急性胰腺炎诊断中的意义

目的 探讨血清淀粉酶（AMY）和脂肪酶（LIP）测定在急性胰腺炎诊断中的价值。方法 对54例急性胰腺炎患者、58例胆结石患者、47例肾结石患者和50例健康对照组人员进行血清淀粉酶（AMY）和脂肪酶（LIP）测定。结果 54例急性胰腺炎中血清淀粉酶和脂肪酶升高的敏感性分别为87．0％和92．6％；联合测定AMY和LIP单项指标阳性率为98．1％；105例非急性胰腺炎患者中，AMY阳性的有12例，LIP阳性的有10例，AMY和LIP的特异性分别为88．6％和90．5％，AMY和LIP同时阴性的特异性为100％。结论 联合测定血清AMY和LIP可提高急性胰腺炎诊断的敏感性和特异性，对急性胰腺炎具有重要的诊断意义。     

血清淀粉酶和脂肪酶联合检测在急性胰腺炎诊断中的应用

目的分析血清淀粉酶(AMY)和脂肪酶(LPS)检测方式在急性胰腺炎诊断中的价值。方法选取2012年1月至2014年2月收治的100例急性胰腺炎患者和100例健康体检者行AMY与LPS检测,分析检测结果及其灵敏度、准确度、特异度。结果重度急性胰腺炎组与轻度急性胰腺炎组患者的AMY、LPS水平高于对照组,差异有统计学意义(P0.05);重度急性胰腺炎组AMY、LPS水平比轻度急性胰腺炎组高,差异有统计学意义(P0.05);AMY、LPS联合检测的准确度、特异度、灵敏度高于两者单独检测结果。结论 AMY联合LPS检测可以为急性胰腺炎提供重要的诊断依据。     

血清淀粉酶和脂肪酶测定在急性胰腺炎诊断中的价值

目的分析血清淀粉酶与脂肪酶检测在急性胰腺炎诊断中的价值,为临床治疗提供诊断信息。方法选取2015年1月至2016年1月在利川市人民医院治疗的62例急性胰腺炎患者作为研究对象,所有患者均进行了血清淀粉酶、脂肪酶检测,统计检测结果的阳性率以及血清淀粉酶与脂肪酶对急性胰腺炎的诊断性能。结果脂肪酶检测阳性率为80.65%(50/62),血清淀粉酶检测阳性率为67.74%(42/62)。两种指标联合检测阳性率为95.16%(59/62),明显高于两项指标单独检测,差异有统计学意义(P0.05)。脂肪酶检测灵敏度为91.8%,特异度为96.5%;血清淀粉酶检测灵敏度为92.1%,特异度为89.6%。两项指标联合检测灵敏度和特异度分别为95.6%、98.7%,灵敏度明显高于两项指标单独检测,差异有统计学意义(P0.05)。结论血清淀粉酶与脂肪酶联合检测提高了诊断的灵敏度,值得推广使用。     

淀粉酶与脂肪酶联合检测在急性胰腺炎中的诊断价值

目的探讨血清淀粉酶(SAMY)、尿淀粉酶(UAMY)和脂肪酶(LIPA)联合检测在急性胰腺炎(AP)诊断中的价值。方法测定118例AP患者于发病不同阶段(2～8h、8～24h、24～48h、48～72h、3～7d、7～10d)的SAMY、UAMY和LIPA。结果 SAMY、UAMY和LIPA的检测结果及阳性率随着发病时间的延长有逐步升高的趋势,尤其是UAMY和LIPA,二者呈平行改变。2～8h时,三者单独检测,阳性率均较低,而三者联合检测阳性率可增至43.2%;72h后SAMY明显降低,造成SAMY检测阳性率降低,而UAMY和LIPA检测阳性率达80%以上,三者联合检测阳性率可达90%以上,且SAMY和LIPA联合检测阳性率可达83.1%。结论 SAMY、UAMY和LIPA联合检测可为AP的诊断提供重要依据。     

血清淀粉酶和脂肪酶联合测定在急性胰腺炎诊断中的意义

目的：探讨联合检测血清淀粉酶（AMY）和脂肪酶（LPS）在急性胰腺炎诊断中的意义。方法分别检测65例急性胰腺炎患者（AP组）、67例其它急腹症患者（非AP组）和60名健康对照组血清AMY和LPS水平。结果在诊断AP过程中,AMY的敏感性72.3%,LPS敏感性86.1%,AMY和LPS联合检测的敏感性96.9%;相对AMY单独检测诊断和LPS单独检测诊断,AMY和LPS联合检测诊断AP的敏感性明显升高（χ^2=15.127,P=0.000;χ^2=4.866,P=0.027）。结论联合检测血清AMY与LPS,可以明显提高AP的诊断敏感性。     

血清脂肪酶测定在急性胰腺炎中的应用

胰腺泡分泌多种消化酶，主要为α－淀粉酶（AMS），脂肪酶（LPS）等。在正常情况下，这些酶经胰腺管分泌至十二指肠，而当胆道疾病或酗酒等原因引起胰腺炎时，这些酶便遣入血清中引起胰腺自身消化。因而，对于这种酶的检测便成为临床诊所急性胰腺炎的主要依据之一。目前，国内大部分地区仍采用血清（AMS）测定来作为急性胰腺炎的诊断实验．那么，血清AMS测定对胰腺炎诊断的灵敏度和持异性到底怎样呢？Steinberg等很早就做了这方面实验观察[1～4]，结果认为血清AMS测定的灵敏度为90％～100％，后来，Clavien[5]以影像结果（B超，CT等…     

Lipase and pancreatic amylase versus total amylase as biomarkers of pancreatitis: an analytical investigation

OBJECTIVE: To evaluate the biomarkers of pancreatitis Colorimetric Lipase, Total Amylase and Pancreatic Amylase (immunoinhibition) assays on the Roche COBAS INTEGRA 700. RESULTS: Pancreatic and Total Amylase assays and Colorimetric Lipase showed excellent imprecision of 1.6 to 2.3% and linearity (slope = 0.94-0.99, y-intercepts-1 to +3 U/L, r = 0.999) over the range of 17 to 900, 35 to 880, and 21 to 150 U/L, respectively. There was an excellent correlation between Pancreatic and Total Amylase: Pancreatic Amylase = 0.99 (+/- 0.02) x Total Amylase-36(+/- 8) (n = 106, r = 0.97, p < 1 x 10(-5), y intercept p < 1 x 10(-5)). Colorimetric Lipase showed some correlation to Total and Pancreatic Amylase results: Colorimetric Lipase = 1.54 (+/- 0.16) x Total Amylase-81(+/- 37) (n = 100, r = 0.70, p < 1 x 10(-6), y intercept p = 0.03), and Colorimetric Lipase = 1.78 (+/- 0.15) x Pancreatic Amylase-50(+/- 29) (n = 99, r = 0.78, p < 1 x 10(-6), y intercept p = 0.09). CONCLUSION: We recommend running the more specific Pancreatic Amylase as biomarker of pancreatitis on the Roche COBAS INTEGRA.     

A review of biomarker utilization in the diagnosis and management of acute pancreatitis reveals amylase ordering is favored in patients requiring laparoscopic cholecystectomy

BackgroundDespite widespread recommendations to favor lipase over amylase in the diagnosis and management of acute pancreatitis, many routine hospital laboratories still offer amylase testing. This study sought to evaluate and compare ordering patterns of amylase and lipase in patients with acute pancreatitis.MethodsWe analyzed 438 patients with acute pancreatitis admitted to our hospital. Data collection included pancreatitis etiology and management as well as biochemical profiles of amylase and lipase. We compared serial ordering patterns, degree of biomarker elevation, and normalization kinetics.ResultsAll patients had at least one lipase ordered during their admission, and only 51 patients (12%) had at least one amylase ordered. On average, lipase was elevated 5 times higher above its respective upper reference limit than amylase at admission. Pancreatitis etiology was skewed toward gallstones in the amylase group as compared to the lipase only group (69% vs. 43%), and surgical patients (laparoscopic cholecystectomy) were more likely to have amylase ordered and/or trended.ConclusionsAmylase measurement was not necessary in the diagnosis and management of 88% of patients with acute pancreatitis. Of patients for whom amylase was ordered, it was common for these patients to be those referred to surgical procedures, possibly because amylase normalization may be documented faster than that of lipase.     

Serum amylase, pancreatic amylase and lipase concentrations in epileptic children treated with carbamazepine monotherapy

BACKGROUND: Serum total amylase and lipase activities have been determined in epileptic patients treated with polytherapy using enzyme-inducing anticonvulsant drugs; however, to our knowledge, serum total amylase, pancreatic amylase and lipase activities have not previously been determined in patients receiving carbamazepine monotherapy. The purpose of this study was to investigate by a prospective, self-controlled method, whether early treatment with carbamazepine monotherapy may alter serum total amylase, pancreatic amylase and lipase concentrations of epileptic children. METHODS: Serum total amylase, pancreatic amylase and lipase activities have been determined in 18 epileptic children before and at 6 and 12 months of treatment with carbamazepine monotherapy. Serum gamma-glutamyltransferase activities were also determined. RESULTS: Serum total amylase concentrations were significantly increased at 6 months of treatment (p=0.034), and serum nonpancreatic amylase concentrations were significantly increased at 6 (p=0.016) and 12 months of treatment (p=0.039), whereas serum pancreatic amylase and lipase concentrations did not significantly change at 6 or 12 months of treatment with carbamazepine monotherapy. Furthermore, serum gamma-glutamyltransferase concentrations were significantly increased at 6 (p=0.000) and 12 months of treatment (p=0.000) with carbamazepine monotherapy. There was no significant correlation between serum nonpancreatic amylase concentrations and serum gamma-glutamyltransferase or carbamazepine concentrations at 6 and 12 months of treatment with carbamazepine monotherapy. CONCLUSIONS: These findings indicate that nonpancreatic amylase concentrations may be increased in patients treated with carbamazepine monotherapy. Therefore, measurement of serum pancreatic amylase and lipase concentrations is suggested in epileptic patients receiving carbamazepine monotherapy with symptoms suggesting pancreatic dysfunction, so that unnecessary discontinuing of treatment with carbamazepine should be avoided.     

血清脂肪酶测定对急性胰腺炎的诊断价值

目的探讨血清脂肪酶(LPS)在急性腹痛时对急性胰腺炎(AP)的鉴别诊断价值。方法将598例急性腹痛患者分为AP组192例和非AP(NAP,包括胆结石30例、肠梗阻15例、急性胆囊炎10例、腹部外伤9例、胰腺恶性肿瘤6例、不明原因腹痛299例、糖尿病6例、上消化道疾病11例、肺部疾病9例、急性肾功能衰竭11例)组406例,同时测定血清LPS和淀粉酶(AMY)。绘制受试者工作特征(ROC)曲线,计算LPS和AMY诊断AP的敏感性、特异性、阳性预测值、阴性预测值。结果 AP组血清AMY和LPS水平明显高于NAP组(P<0.01)。LPS和AMY均以正常参考范围上限的3倍(180、300 U/L)为临界值时,其灵敏度、特异性、阳性预测值和阴性预测值分别为87.5%、62.5%,89.4%、95.3%,80.0%、86.3%和94.7%、88.2%;血清LPS和AMY诊断AP的ROC曲线下面积分别为0.959和0.921,二者测定结果之间呈正相关(r=0.90)。结论血清LPS对AP的诊断性能优于AMY,对AP的诊断具有重要的临床意义。     

重症急性胰腺炎患者胰腺感染的相关因素分析及防治措施

目的 探讨重症急性胰腺炎（SAP）患者胰腺感染发生的相关因素及其预防措施。方法 对246例SAP患者的性别、病因、Ranson评分、APACHEⅡ评分、低氧血症、腹腔室隔综合征、肾功能衰竭、血淀粉酶水平、尿淀粉酶水平、手术与否、禁食天数、是否应用呼吸机及生长抑素等因素进行多因素分析。结果 246例SAP患者中30例（12．2％）发生胰腺感染。胰腺感染组禁食时间明显多于无胰腺感染组（P〈0．01）。低氧血症、肾功能衰竭、手术与否以及是否应用有创呼吸机在两组之间比较差异有显著性（P〈0．05或O．01）。结论 在SAP发病过程中。禁食时间较长、低氧血症、肾功能衰竭、手术以及应用有创呼吸机可能是导致胰腺感染发生的重要因素。     

纳洛酮治疗急性胰腺炎的临床疗效

目的探讨纳洛酮治疗急性胰腺炎的疗效。方法急性胰腺炎患者共44例,分为纳洛酮组与对照组,纳洛酮组每日静脉输注纳洛酮4mg加入5%葡萄糖溶液250ml中,其余常规治疗同对照组,观察血、尿淀粉酶及C反应蛋白(CRP)水平变化及临床症状纳络酮组改善程度。结果临床症状纳洛酮组较对照组恢复稍快,但无统计学差异;纳洛酮组治疗后第1、3、5、7天血淀粉酶水平明显低于对照组(P<0.05),尿淀粉酶水平于治疗后第1、5、7天及第2、3天较对照组明显降低(P<0.05,P<0.01),恢复到正常水平较对照组提前;纳洛酮组CRP水平在治疗前,治疗后3天开始有显著差别(P<0.01),对照组治疗前、后无明显差别(P>0.05)。结论静脉应用纳洛酮有助于急性胰腺炎的炎症恢复。