慢性胰腺炎患者血清淀粉酶升高：急性发作还是巨淀粉酶血症？
Elevated serum amylase in patients with chronic pancreatitis: acute attack or macroamylasemia?
作者信息
Gubergrits Natalya, Golubova Oksana, Lukashevich Galina, Fomenko Pavlo
机构信息
Department of Internal Medicine, Donetsk National Medical University, Pr. Grinkevicha, 8-3, 83001 Donetsk, Ukraine.
Department of Internal Medicine, Donetsk National Medical University, Pr. Grinkevicha, 8-3, 83001 Donetsk, Ukraine.
出版信息
Pancreatology. 2014 Mar-Apr;14(2):114-6. doi: 10.1016/j.pan.2013.12.004. Epub 2014 Jan 8.
BACKGROUND AND AIM
Asymptomatic patients with chronic pancreatitis not infrequently have elevated concentrations of amylase, even though detailed examination reveals no indication of an acute exacerbation.
METHODS
One hundred and eighty-six consecutive patients with chronic pancreatitis were examined clinically and, if indicated, by ultrasonography and computed tomography. In addition, all patients underwent determination of serum amylase and serum lipase as well as amylase/creatinine clearance, followed as required by a polyethylene glycol test and/or chromatography to demonstrate macroamylase.
RESULTS
Twenty (11%) of the 186 patients had macroamylasemia, and 15 of these 20 had hyperamylasemia. In the remaining five cases the serum amylase levels were within the normal range.
CONCLUSIONS
Patients with asymptomatic chronic pancreatitis and hyperamylasemia should first be investigated for macroamylasemia, before initiating any costly or complex procedures in the attempt to demonstrate a clinically silent or only mildly symptomatic attack of their disease.
背景与目的
慢性胰腺炎无症状患者的淀粉酶浓度常常升高，即便详细检查未发现急性加重的迹象。
方法
对186例连续性慢性胰腺炎患者进行临床检查，必要时行超声检查和计算机断层扫描。此外，所有患者均测定血清淀粉酶、血清脂肪酶以及淀粉酶/肌酐清除率，必要时进行聚乙二醇试验和/或色谱分析以证实巨淀粉酶血症。
结果
186例患者中有20例（11%）存在巨淀粉酶血症，这20例中的15例有高淀粉酶血症。其余5例血清淀粉酶水平在正常范围内。
结论
对于无症状慢性胰腺炎伴高淀粉酶血症的患者，在启动任何昂贵或复杂的检查以证实其疾病的临床隐匿性发作或仅有轻度症状性发作之前，应首先排查巨淀粉酶血症。
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