Hiatt J R, Calabria R P, Passaro E, Wilson S E
Department of Surgery, Harbor-UCLA Medical Center 90024.
Am J Surg. 1987 Nov;154(5):490-2. doi: 10.1016/0002-9610(87)90261-3.
Serial serum amylase determinations were made in 85 consecutive patients who presented with an initially elevated value. In 35 patients (Group A), the clinical findings were consistent with biliary tract disease. All underwent cholecystectomy for documented cholelithiasis within a week of diagnosis, and 23 percent had choledocholithiasis as well. Fifty patients (Group B) presented with a first episode of acute alcoholic pancreatitis. An amylase profile, consisting of initial and final values and the daily rate of change, was significantly different between the two groups. The initial serum amylase value was higher in Group A patients and decreased more rapidly to a lower value than in Group B patients. We conclude that both the initial value and pattern of serum amylase decay distinguish the hyperamylasemia of biliary tract disease from that of alcoholic pancreatitis.
对85例血清淀粉酶初始值升高的连续患者进行了系列血清淀粉酶测定。35例患者（A组）临床表现符合胆道疾病。所有患者在诊断后一周内均因确诊的胆石症接受了胆囊切除术，其中23%还患有胆总管结石。50例患者（B组）首次发作急性酒精性胰腺炎。两组之间的淀粉酶谱，包括初始值、终末值和每日变化率，存在显著差异。A组患者的初始血清淀粉酶值较高，且比B组患者更快地降至较低值。我们得出结论，血清淀粉酶的初始值和衰减模式均可区分胆道疾病的高淀粉酶血症与酒精性胰腺炎的高淀粉酶血症。
