血清淀粉酶和脂肪酶浓度及其比值对急性胰腺炎诊断价值的研究

目的探讨血清淀粉酶、脂肪酶浓度及脂肪酶／淀粉酶浓度比值在急性胰腺炎的病因分类和指导疾病的分级诊断中的作用。方法收集急性胰腺炎患者128例，按照病因分为胆源性、酒精性、其他病因三组，按照病情严重程度结合CT检查结果分为轻、中、重三组，比较各组间血清淀粉酶、脂肪酶浓度，脂肪酶／淀粉酶浓度比值的差异。结果酒精性急性胰腺炎患者的血清淀粉酶水平低于胆源性和其他病因患者（P=0．005、0．026），胆源性和其他病因组间淀粉酶浓度差异无统计学意义。各病因分组之间，脂肪酶浓度和脂肪酶／淀粉酶浓度比值的差异均无统计学意义。按照疾病严重程度分组研究中，淀粉酶、脂肪酶浓度以及脂肪酶／淀粉酶浓度比值在各组间的差异无统计学意义。结论血清淀粉酶浓度在鉴别酒精性和非酒精性急性胰腺炎方面有指示作用，而脂肪酶浓度及脂肪酶／淀粉酶浓度比值不足以用来鉴别急性胰腺炎的病因，也不能单独作为指示疾病严重程度的指标。

The value of serum amylase and lipase concentrations and lipase/amylase ratio in diagnosis of acute pancreatitis

Objective To explore the value of the levels of serum amylase and lipase as well as the serum lipase/ amylase ratio on establishing the etiology and predicting the severity of acute pancreatitis. Methods One hundred and twenty-eight acute panereatitis patients were divided into three groups according to the etiology （biliary etiology group, alcohol etiology group and other etiology group）. They were divided into three degree according to clinical and CT scan. Serum amylase level, serum lipase level and serum lipase/amylase ratio were detected. Results The level of serum amylase was lower in alcoholic pancreatitis patients compared with the other two groups （P = 0. 005, 0. 026, respectively）. But there was no difference in the other two groups for serum amylase level （P = 0. 568 ）. There were no differences of the serum amylase level, serum lipase level and serum lipase/amylase ratio in different degree of the severity （P = 0. 266, 0. 743, 0. 624, respectively）. Conclusion Serum amylase level is able to identify alcoholic and nonalcoholic acute pancreatitis. Serum lipase level is not sufficient either to establish the etiology or to predict the severity of acute pancreatitis. Furthermore, the serum lipase/amylase ratio is not useful enough to distinguish the etiology or severity of the acute pancreatitis.