CT表现与淀粉酶改变在急性胰腺炎病程中的诊断价值

目的：评价CT表现与淀粉酶改变在急性胰腺炎病程中的诊断价值。方法：收集已确诊的急性胰腺炎157例，将其CT改变分为五个级别，各级病例分别与相应的血清、尿液淀粉酶数值对比分析。结果：在CT显示为A级时，血尿液淀粉酶大多为轻度升高（30/41例），B级时以中（27/40例）、高度（13/40例）为主，C级时显著升高（38/44例），D级时趋向下降，中度升高占69.6%（16/23例），E级下降明显，轻度升高占66.7%（6/9例）。结论：CT检查可以准确地反映B、C、D、E级的病理变化，明显优于血清、尿液淀粉酶值的改变，而对A级表现，CT诊断困难，此时应依靠临床症状及体征，结合血清、尿液淀粉酶的变化来作出诊断。

Diagnostic value of CT finding and the changing of amylase in acute pancreatitis

Objective: To evaluate the diagnostic value of CT finding and the changing of amylase in acute pancreatitis. Methods: 157 cases with acute pancreatitis were divided into five grades based on CT findings, and the CT gradings relevant to the serum and urine amylase were analyzed. Results: The serum and urine amylase increased slightly in grade A(30/41cases), moderately (27/40cases) or high (13/40cases) in grade B, markedly in grade C(38/44cases), but tended to decrease in grade D, increased moderately in 69.6%(16/23cases), and decreased dramatically in grade E and increased slightly in 66.7%(6/9cases). Conclusion: CT examination is superior to the serum and urine amylase in evaluation of acute pancreatitis with grade B, C, D and E, but in grade A, it is difficult for CT imaging. The accurate diagnosis should be based on the changing of the serum and urine amylase combined with the clinical symptoms and signs.