Endocrinology and Obstetric Medicine, Mater Health, Brisbane, Queensland, Australia.
Emerg Med Australas. 2022 Feb;34(1):6-8. doi: 10.1111/1742-6723.13882. Epub 2021 Oct 15.
Acute pancreatitis is a common reason for presentation to EDs. The criteria for diagnosis of acute pancreatitis are defined by the revised Atlanta classification. Patients with diabetes mellitus are at increased risk of acute pancreatitis. Uncomplicated diabetes mellitus, complications such as ketoacidosis and newer medications used in the treatment of hyperglycaemia may all be associated with elevated serum lipase and amylase in the absence of acute pancreatitis. Checkpoint inhibitors may also precipitate acute type 1 diabetes mellitus and be associated with elevated lipase and amylase. Finally, individuals with diabetes mellitus are at increased risk of hypertriglyceridaemic pancreatitis, which may be associated with falsely normal lipase and amylase because of laboratory interference. Awareness of these factors in individuals with diabetes mellitus presenting to EDs with symptoms suggestive of acute pancreatitis is important for accurate diagnosis.
急性胰腺炎是急诊科就诊的常见原因。急性胰腺炎的诊断标准由修订后的亚特兰大分类定义。糖尿病患者患急性胰腺炎的风险增加。单纯性糖尿病、酮症酸中毒等并发症以及用于治疗高血糖的新型药物，在没有急性胰腺炎的情况下，都可能与血清脂肪酶和淀粉酶升高有关。检查点抑制剂也可能引发急性 1 型糖尿病，并与脂肪酶和淀粉酶升高有关。最后，糖尿病患者患高甘油三酯血症性胰腺炎的风险增加，由于实验室干扰，脂肪酶和淀粉酶可能假性正常。在急诊科出现疑似急性胰腺炎症状的糖尿病患者中，了解这些因素对于准确诊断非常重要。
