新冠肺炎患者存在肺外胰酶升高而非胰腺炎。
Patients With Coronavirus Disease 2019 Interstitial Pneumonia Exhibit Pancreatic Hyperenzymemia and Not Acute Pancreatitis.
机构信息
From the Department of Gastroenterology, San Carlo Hospital, Potenza.
Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital.
出版信息
Pancreas. 2021;50(5):732-735. doi: 10.1097/MPA.0000000000001824.
OBJECTIVES
Gastrointestinal manifestations of coronavirus disease 19 (COVID-19) have been well established, but pancreatic involvement is under debate. Our aims were to evaluate the presence of acute pancreatitis in COVID-19 patients and to assess the frequency of pancreatic hyperenzymemia.
METHODS
From April 1, 2020, to April 30, 2020, 110 consecutive patients (69 males, 41 females; mean age, 63.0 years; range, 24-93 years) met these criteria and were enrolled in the study. The clinical data and serum activity of pancreatic amylase and lipase were assayed in all patients using commercially available kits.
RESULTS
None of the patients studied developed clinical signs or morphological alterations compatible with acute pancreatitis. However, it was found that 24.5% of the patients had amylase values above 53 IU/L and 16.4% had lipase values above 300 IU/L. Only 1 patient (0.9%) had both amylase and lipase values in excess of 3-fold the upper normal limit without clinical signs of pancreatitis.
CONCLUSIONS
The presence of pancreatic hyperenzymemia in a patient with COVID-19 requires the management of these patients be guided by clinical evaluation and not merely by evaluation of the biochemical results.
目的
新型冠状病毒病（COVID-19）的胃肠道表现已得到充分证实，但胰腺受累仍存在争议。我们的目的是评估 COVID-19 患者中是否存在急性胰腺炎，并评估胰腺高酶血症的发生率。
方法
2020 年 4 月 1 日至 2020 年 4 月 30 日，符合这些标准的 110 例连续患者（69 例男性，41 例女性；平均年龄 63.0 岁；范围 24-93 岁）被纳入研究。使用市售试剂盒检测所有患者的临床数据和血清淀粉酶和脂肪酶活性。
结果
研究中没有患者出现符合急性胰腺炎的临床体征或形态改变。然而，发现 24.5%的患者淀粉酶值超过 53IU/L，16.4%的患者脂肪酶值超过 300IU/L。只有 1 例（0.9%）患者的淀粉酶和脂肪酶值超过正常上限的 3 倍，但无胰腺炎的临床体征。
结论
COVID-19 患者存在胰腺高酶血症时，需要根据临床评估而非仅根据生化结果来指导这些患者的治疗。
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