内镜逆行胰胆管造影过程中取胆汁行淀粉酶检测的临床意义

目的 ：研究内镜逆行胰胆管造影（ERCP）过程中取胆汁行淀粉酶（AMY）检测的临床意义。方法 ：对本中心拟行ERCP的部分患者在造影前行血清AMY测定，其中一部分患者在造影过程中取胆汁行AMY测定。根据造影结果将患者分组。结果 ：胰胆管合流异常（AJPB）组胆汁AMY水平显著高于长共同通道（LCC）组及短共同通道（SCC）组，而LCC组胆汁AMY显著高于SCC组。AJPB组胆汁AMY显著高于血清AMY。结论 ：胆汁AMY水平高低与胰胆管共同通道长度有关;胆汁高AMY水平是诊断胰胆反流的参考指标，检测胆汁AMY可作为诊断AJPB的重要辅助手段。对共同通道长度未达到AJPB诊断标准，但胆汁AMY明显高于血清水平者，也应视为AJPB一样处理。

The clinical significance of detecting amylase level of bile during ERCP

Objective To elucidate the clinical significance of detecting amylase level of bile during ERCP.Methods Bile samples for amylase measurement were taken from selected patients who underwent ERCP.According to their radiological and clinical manifestations,these patients were divided into abnormal junction of pancreatic and bile ducts(AJPB),short common channel(SCC) and long common channel(LCC) groups.Results The amylase level of bile of AJPB group was significantly higher than that of SCC and LCC groups,and the amylase level of bile of LCC group was much higher than that of SCC group.Furthermore,in AJPB group,the amylase level of bile was significantly higher than serum level.Conclusions Amylase level of bile is partly dependent on the length of pancreaticobiliary common channel,and a longer common channel usually is accompanied with a higher amylase level of bile.An unusually high amylase level of bile is a reliable evidence for diagnosing pancreaticobiliary reflux,and measuring amylase content of bile provides an important and adjunctive tool for diagnosing pancreaticobiliary maljunction,especially for those with a common channel shorter than 15 mm,and these patients should be treated as AJPB.