Weaver D W, Busuito M J, Bouwman D L, Wilson R F
Crit Care Med. 1985 Jul;13(7):532-3. doi: 10.1097/00003246-198507000-00003.
To understand better the incidence and meaning of hyperamylasemia in the intensive care setting, cellulose acetate membrane electrophoresis was used to measure the isoenzymes of serum amylase in 192 patients with a variety of critical illnesses. Seventy of these patients had elevated serum amylase levels, but none had clinical or biochemical evidence of acute pancreatitis or renal failure. Of the 70 patients who had hyperamylasemia, in only 18 (26%) was it due solely to an elevation of the pancreatic isoamylase fraction. The remaining 52 patients were hyperamylasemic due to elevations in the nonpancreatic isoamylase fraction or elevations in both pancreatic and nonpancreatic isoamylase fractions. These data indicate that hyperamylasemia in the absence of clinical pancreatic disease is common in the ICU and is frequently caused by nonpancreatic production of serum amylase. Caution is, therefore, advised in interpreting elevated serum amylase levels in critically ill patients.
为了更好地了解重症监护环境下高淀粉酶血症的发生率及意义，采用醋酸纤维素膜电泳法对192例患有各种危重病的患者血清淀粉酶同工酶进行了测定。其中70例患者血清淀粉酶水平升高，但均无急性胰腺炎或肾衰竭的临床或生化证据。在70例高淀粉酶血症患者中，仅18例（26%）是单纯由于胰腺同工淀粉酶组分升高所致。其余52例患者高淀粉酶血症是由于非胰腺同工淀粉酶组分升高或胰腺和非胰腺同工淀粉酶组分均升高所致。这些数据表明，在没有临床胰腺疾病的情况下，高淀粉酶血症在重症监护病房很常见，且常常是由血清淀粉酶的非胰腺来源引起的。因此，在解读重症患者血清淀粉酶水平升高时应谨慎。
