Gwozdz G P, Steinberg W M, Werner M, Henry J P, Pauley C
Department of Medicine, George Washington University Medical Center, Washington, D.C.
Clin Chim Acta. 1990 Mar 15;187(3):243-54. doi: 10.1016/0009-8981(90)90109-6.
We compared the diagnostic sensitivities of serum amylase, lipase (assayed enzymatically and immunologically), trypsinogen and elastase-1, the 2-h-timed urine amylase excretion and the ratio of amylase and creatinine clearances in the recognition of acute pancreatitis. Serial serum and urine findings from 39 patients with acute pancreatitis, and from 42 patients with non-pancreatic causes of abdominal pain (controls), as well as findings from 24 healthy subjects (normals) were studied. Decision thresholds were established for each parameter using either the control or the normal population, and the resulting diagnostic sensitivities determined. On hospital admission, all serum assays were equally sensitive, but on subsequent days lipase, trypsinogen and elastase-1 assays all significantly surpassed the sensitivity of the serum amylase assay. On the second and subsequent hospitalization days, determination of timed urine amylase excretion offered no advantage over the serum amylase, and the ratio of amylase and creatinine clearances lacked discrimination altogether.
我们比较了血清淀粉酶、脂肪酶（采用酶法和免疫法测定）、胰蛋白酶原和弹性蛋白酶-1、2小时定时尿淀粉酶排泄量以及淀粉酶与肌酐清除率比值在急性胰腺炎诊断中的敏感性。研究了39例急性胰腺炎患者、42例非胰腺性腹痛患者（对照组）的系列血清和尿液检查结果，以及24例健康受试者（正常组）的检查结果。使用对照组或正常人群为每个参数确定决策阈值，并确定由此产生的诊断敏感性。入院时，所有血清检测的敏感性相同，但在随后几天，脂肪酶、胰蛋白酶原和弹性蛋白酶-1检测的敏感性均显著超过血清淀粉酶检测。在住院第二天及之后，定时尿淀粉酶排泄量的测定相对于血清淀粉酶并无优势，而淀粉酶与肌酐清除率比值完全缺乏鉴别能力。
