Ventrucci M, Pezzilli R, Montone L, Plate L, Buonamici L, Bergami R, Conci T
Cattedra di Gastroenterologia, Università di Bologna, Italy.
Ital J Gastroenterol. 1992 Mar-Apr;24(3):115-8.
Serum amylase, pancreatic isoamylase, lipase, trypsinogen and elastase-1 were measured in 100 consecutive patients who were emergency admissions to a surgical department, and in 27 selected patients with proven acute pancreatitis who served as controls. The final diagnoses in the 100 patients of the study group were: acute pancreatitis in eight patients, other digestive diseases in 87, and urogenital tract diseases in five. In the control group, pancreas-specific enzymes were abnormally high in all patients and amylase in 26 out of 27. In the study group, all enzymes were markedly high in all eight patients with acute pancreatitis. In the remaining 92 patients, serum amylase was abnormally high in seven, and at least one pancreatic enzyme was elevated in 16. These elevations were generally mild. The diagnostic efficiency, i.e., the percentage of patients correctly classified, was 96% for pancreatic isoamylase and lipase, 93% for amylase, 91% for elastase-1, and 84% for trypsinogen. We conclude that serum lipase turbidimetric assay is the most suitable test for emergency diagnosis of acute pancreatitis, because it is highly sensitive and specific and simply and quickly performed.
对100名连续入住外科的急诊患者以及27名经证实患有急性胰腺炎的选定患者（作为对照）测定了血清淀粉酶、胰腺同工淀粉酶、脂肪酶、胰蛋白酶原和弹性蛋白酶-1。研究组100名患者的最终诊断结果为：8例急性胰腺炎，87例其他消化系统疾病，5例泌尿生殖道疾病。对照组中，所有患者的胰腺特异性酶均异常升高，27例中有26例淀粉酶异常升高。研究组中，8例急性胰腺炎患者的所有酶均显著升高。其余92例患者中，7例血清淀粉酶异常升高，16例至少有一种胰腺酶升高。这些升高通常较轻。胰腺同工淀粉酶和脂肪酶的诊断效率（即正确分类患者的百分比）为96%，淀粉酶为93%，弹性蛋白酶-1为91%，胰蛋白酶原为84%。我们得出结论，血清脂肪酶比浊法是急性胰腺炎急诊诊断最适合的检测方法，因为它高度敏感、特异，且操作简单快速。
