Humphries L L, Adams L J, Eckfeldt J H, Levitt M D, McClain C J
Ann Intern Med. 1987 Jan;106(1):50-2. doi: 10.7326/0003-4819-106-1-50.
Hyperamylasemia, which has been reported in patients with the eating disorders anorexia nervosa and bulimia, generally has been thought to result from pancreatitis. To evaluate the mechanisms of hyperamylasemia, we measured amylase, lipase, and isoamylase activity in 17 consecutive patients admitted to the eating disorder unit. Six patients had elevated amylase activity, and 5 of these 6 had isolated increases in salivary isoamylase activity. Six other patients had normal serum total amylase activity but modest elevations in the salivary isoamylase fraction. No patient developed clinical evidence of pancreatitis during hospitalization. Thus, the hyperamylasemia in patients with anorexia and bulimia often is caused by increased salivary-type amylase activity. The appropriate diagnostic test for hyperamylasemia in patients with anorexia or bulimia is the simple measurement of serum lipase or pancreatic isoamylase activity. If these levels are found to be normal, further tests to exclude pancreatitis are unnecessary.
高淀粉酶血症在患有神经性厌食症和贪食症等饮食失调症的患者中已有报道，通常被认为是由胰腺炎引起的。为了评估高淀粉酶血症的机制，我们对连续收治到饮食失调科的17例患者进行了淀粉酶、脂肪酶和同工淀粉酶活性的测定。6例患者淀粉酶活性升高，其中5例唾液同工淀粉酶活性单独升高。另外6例患者血清总淀粉酶活性正常，但唾液同工淀粉酶部分略有升高。住院期间没有患者出现胰腺炎的临床证据。因此，厌食症和贪食症患者的高淀粉酶血症通常是由唾液型淀粉酶活性增加引起的。对于厌食症或贪食症患者高淀粉酶血症的合适诊断测试是简单测量血清脂肪酶或胰腺同工淀粉酶活性。如果发现这些水平正常，则无需进一步检查以排除胰腺炎。
