Muniraj Thiruvengadam, Dang Saurabh, Pitchumoni Capecomorin S
Section of Digestive Disease, Yale University School of Medicine, New Haven, CT.
Department of surgery, Mount Sinai Beth Israel Medical center, New York, NY.
J Crit Care. 2015 Dec;30(6):1370-5. doi: 10.1016/j.jcrc.2015.08.020. Epub 2015 Sep 1.
Elevation in serum levels of pancreatic enzymes (Hyperamylasemia and/or Hyperlipasemia) can occur in any Intensive Care Unit (ICU) patient either as a result of true acute pancreatitis (AP) or as a reflection of a non-pancreatic disease. Although most patients may not have clinical pancreatitis, identifying true acute pancreatitis in the ICU setting may be critical in the presence of associated co-morbid conditions of the disease for which the patient is being managed. With neither amylase nor lipase being specific for pancreatitis, it is important for the clinician to be aware of different causes of hyperamylasemia and hyperlipasemia, especially when clinical diagnosis of pancreatitis is unclear. This review will focus on understanding different non-pancreatic conditions where there is elevation of pancreatitis enzymes and to identify true acute pancreatitis in critically ill patients without typical symptoms.
血清胰酶水平升高（高淀粉酶血症和/或高脂肪酶血症）可出现在任何重症监护病房（ICU）患者中，其原因可能是真正的急性胰腺炎（AP），也可能是反映了非胰腺疾病。尽管大多数患者可能没有临床胰腺炎，但在ICU环境中识别真正的急性胰腺炎对于正在接受治疗的患者所患疾病的相关合并症而言可能至关重要。由于淀粉酶和脂肪酶都不是胰腺炎的特异性指标，临床医生了解高淀粉酶血症和高脂肪酶血症的不同病因非常重要，尤其是在胰腺炎临床诊断不明确时。本综述将重点关注理解胰腺炎酶升高的不同非胰腺情况，并在没有典型症状的危重症患者中识别真正的急性胰腺炎。
