Kim Young Sun, Chang Jae Hyuck, Kim Tae Ho, Kim Chang Whan, Kim Jae Kwang, Han Sok Won
Department of Internal Medicine, College of Medicine, the Catholic University of Korea, Seoul, Korea.
Medicine (Baltimore). 2020 Jan;99(3):e18861. doi: 10.1097/MD.0000000000018861.
Serum amylase levels in patients with acute pancreatitis often remain or fluctuate above the upper normal limit for over a week. This study investigated the clinical characteristics of patients with prolonged hyperamylasemia and their prognoses, including recurrence.We retrospectively analyzed patients with first attacks of acute pancreatitis in a single center between March 2010 and December 2016. Patients were divided into 2 groups according to normalization of the serum amylase levels within a week.A total of 313 patients were enrolled after exclusion. The serum amylase levels were normalized within a week in 205 patients (65.5%, group 1) and elevated over a week in 108 patients (34.5%, group 2). Group 2 was more related to alcohol, higher computed tomography (CT) severity index, local pancreatic complication, and moderately severe pancreatitis than group 1 (P < .05). Recurrent pancreatitis developed significantly more in group 2 (39.8%) than in group 1 (19.5%) (P < .001). The factors related to recurrent pancreatitis were amylase group, sex, alcohol, CT severity index, necrosis, and severity of pancreatitis (P < .05). Multivariate analysis showed that recurrent pancreatitis was independently associated with amylase group (odds ratio [OR] 2.123, 95% confidence interval [CI]= 1.227-3.673, P = .007) and alcohol (OR 2.023, 95% CI 1.134-3.611, P = .017).In conclusion, prolonged hyperamylasemia over a week is associated with recurrence of acute pancreatitis.
急性胰腺炎患者的血清淀粉酶水平常持续或波动高于正常上限一周以上。本研究调查了长期高淀粉酶血症患者的临床特征及其预后，包括复发情况。我们回顾性分析了2010年3月至2016年12月在单一中心首次发作急性胰腺炎的患者。根据血清淀粉酶水平在一周内是否恢复正常将患者分为两组。排除后共纳入313例患者。205例患者（65.5%，第1组）的血清淀粉酶水平在一周内恢复正常，108例患者（34.5%，第2组）的血清淀粉酶水平升高超过一周。第2组比第1组与酒精的相关性更强，计算机断层扫描（CT）严重程度指数更高，胰腺局部并发症更多，且中度重症胰腺炎更多（P<0.05）。第2组复发性胰腺炎的发生率（39.8%）显著高于第1组（19.5%）（P<0.001）。与复发性胰腺炎相关的因素有淀粉酶分组、性别、酒精、CT严重程度指数、坏死及胰腺炎严重程度（P<0.05）。多因素分析显示，复发性胰腺炎与淀粉酶分组（比值比[OR]2.123，95%置信区间[CI]=1.227 - 3.673，P=0.007）和酒精（OR 2.023，95%CI 1.134 - 3.611，P=0.017）独立相关。总之，超过一周的长期高淀粉酶血症与急性胰腺炎的复发有关。
