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首页> 外文期刊>ANZ journal of surgery >Evaluation of amylase and lipase in the diagnosis of acute pancreatitis.
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Evaluation of amylase and lipase in the diagnosis of acute pancreatitis.

机译：淀粉酶和脂肪酶在急性胰腺炎诊断中的评估。

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BACKGROUND: The diagnosis of acute pancreatitis relies heavily on a raised amylase. METHODS: In the present study patients were prospectively categorized, without knowledge of pancreatic enzyme levels, into acute pancreatitis (AP; n = 51), disease controls (n = 35), indeterminate as to pancreatitis (n = 189) or exclusions (non-pancreatitis diseases where amylase may be elevated; n = 53). RESULTS: Enzyme levels were analysed by receiver operator characteristics (ROC) curves, with specificity > 80%. Day 1 serum lipase gave the greatest diagnostic accuracy (area under ROC curve = 0.128; P = 0.041 vs serum amylase). At the calculated diagnostic threshold of 208 U/L, lipase gave a sensitivity of 67% and a specificity of 97%. Other diagnostic thresholds (day 1) were: serum total amylase, 176 U/L (ROC 0.104, sensitivity 45%, specificity 97%), urinary total amylase, 550 U/L (ROC 0.108, sensitivity 62%, specificity 97%) and serum pancreatic isoamylase, 41 U/L (ROC 0.107, sensitivity 63%, specificity 85%). At delayed diagnosis (3 days) no enzyme was superior to lipase. The combination of lipase and amylase did not increase diagnostic accuracy. Conclusion: Serum lipase is recommended for diagnosis of AP, both early and late in the disease. Although highly specific when elevated, all pancreatic enzymes have low sensitivity for diagnosis.
机译：背景：急性胰腺炎的诊断严重依赖于淀粉酶升高。方法：在本研究中，在不了解胰腺酶水平的情况下，将患者前瞻性分类为急性胰腺炎（AP; n = 51），疾病对照（n = 35），不确定的胰腺炎（n = 189）或排除因素（非淀粉酶可能升高的胰腺炎; n = 53）。结果：通过受体操作者特征（ROC）曲线分析了酶的水平，特异性> 80％。第1天血清脂肪酶的诊断准确性最高（相对于血清淀粉酶，ROC曲线下的面积= 0.128; P = 0.041）。在计算出的208 U / L的诊断阈值下，脂肪酶的灵敏度为67％，特异性为97％。其他诊断阈值（第1天）为：血清总淀粉酶176 U / L（ROC 0.104，敏感性45％，特异性97％），尿总淀粉酶，550 U / L（ROC 0.108，敏感性62％，特异性97％）血清胰异淀粉酶41 U / L（ROC 0.107，敏感性63％，特异性85％）。在延迟诊断（3天）时，没有一种酶优于脂肪酶。脂肪酶和淀粉酶的组合不能提高诊断准确性。结论：建议在疾病的早期和晚期使用血清脂肪酶诊断AP。尽管升高时具有高度特异性，但所有胰酶对诊断的敏感性均较低。

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