Satz N, Jacot des Combes A, Meier L, Hollinger A, Knoblauch M
Medizinische Abteilung, Kreisspital Männedorf.
Schweiz Rundsch Med Prax. 1990 Mar 13;79(11):314-7.
In 233 sera, taken from 112 patients and 20 healthy blood-donors, we have compared RapiTex-Lipase, a semi quantitative immunochemical latex test for the determination of the lipase, with the conventional quantitative method of determination in order to establish its diagnostical value as a screening test for acute pancreatitis. It appeared that, with a positive result of the test increased values of lipase were found in 98% of the cases, but that a negative result of the test did not exclude an increased lipase. The sensitivity of the test as to the quantitative determination of the lipase depended directly on the activity of the lipase and turned out to be acceptable at 88% only with values 4 X higher than the upper limit of the normal range. With values 5 X higher and more, it reached 100%. Even if the test, due to its very high level of discrimination, did not show a reaction in every case of unspecific extrapancreatic hyperlipasemia, its organ-specificity for the pancreas was reduced and came to 80 to 96% in patients with renal insufficiency, diseases of the liver, abuse of alcohol and in various non-pancreatic intra- or extra-abdominal affections. In 16/18 patients with acute pancreatitis the test used for screening turned out positive (sensitivity 89%), two patients with values between 2 and 4 X the upper limit of the norm had a negative test.(ABSTRACT TRUNCATED AT 250 WORDS)
我们从112例患者和20名健康献血者中采集了233份血清，将用于测定脂肪酶的半定量免疫化学乳胶试验RapiTex - Lipase与传统定量测定方法进行比较，以确定其作为急性胰腺炎筛查试验的诊断价值。结果显示，试验结果为阳性时，98%的病例脂肪酶值升高，但试验结果为阴性并不排除脂肪酶升高。该试验对脂肪酶定量测定的敏感性直接取决于脂肪酶的活性，仅在脂肪酶值高于正常范围上限4倍时，敏感性才为88%，勉强可以接受。当脂肪酶值高于正常范围上限5倍及以上时，敏感性达到100%。即使该试验由于其高度的鉴别性，并非在每例非特异性胰腺外高脂血症病例中都出现反应，但其对胰腺的器官特异性仍有所降低，在肾功能不全、肝脏疾病、酗酒患者以及各种非胰腺的腹腔内或腹腔外疾病患者中，器官特异性降至80%至96%。在18例急性胰腺炎患者中，用于筛查的试验结果有16例呈阳性（敏感性89%），2例脂肪酶值在正常范围上限2至4倍之间的患者试验结果为阴性。（摘要截选至250字）
