Aidoo Nathaniel Ebo, Ofori Emmanuel Kwaku, Boima Vincent, Nyarko Eric Nana Yaw, Osei John Cletus, Darkwah Clement G, Gayflor Morris O, Amponsah Seth K, Asare-Anane Henry
Department of Chemical Pathology, University of Ghana Medical School, Accra, Ghana.
MDS-Lancet Laboratories Ghana Ltd, East Legon, Accra, Ghana.
Pract Lab Med. 2024 Sep 18;42:e00429. doi: 10.1016/j.plabm.2024.e00429. eCollection 2024 Nov.
Enteric fever (EF), a potentially fatal febrile illness, is prevalent in developing countries. Elevated levels of lipase and amylase in serum, typically associated with acute pancreatitis (AP), have been observed in patients with EF. The elevated enzymes in both conditions may lead to diagnostic confusion and care delays. This study aimed to determine biochemical indices that are peculiar to EF and AP.
A cross-sectional comparative study was conducted at the Korle-Bu Teaching Hospital, Ghana. Volunteers were categorized into three groups: EF (n = 32), AP (n = 30) and healthy controls (n = 31). A standard questionnaire was used to collect socio-demographic and clinical information from the participants. Blood and stool samples were obtained, followed by biochemical analysis: total amylase, lipase, pancreatic amylase, serum elastase 1, hepatic enzymes, calcium, magnesium, phosphate, stool colour, stool pH, and stool fat presence.
The AP group displayed higher total amylase, lipase, elastase-1, alkaline phosphatase, aspartate aminotransferase, and gamma-glutamyl transferase levels compared to the EF and control groups ( < 0.05 respectively). Elastase 1 levels were found to be high in all AP participants, whereas no elevations were observed in the EF group. Positive associations were observed in the AP and EF groups for lipase vs total amylase (ρ = .543, = 0.001; ρ = .543, = 0.001 for both).
Elevated levels of total/pancreatic amylase and lipase were found to be indicative of a patient with AP and EF. Further, elastase-1 was found to be a good biomarker to distinguish between AP and EF.
肠热症（EF）是一种在发展中国家普遍存在的潜在致命性发热疾病。在肠热症患者中观察到血清脂肪酶和淀粉酶水平升高，这通常与急性胰腺炎（AP）相关。两种病症中酶水平的升高都可能导致诊断混淆和治疗延误。本研究旨在确定肠热症和急性胰腺炎特有的生化指标。
在加纳的科勒-布教学医院进行了一项横断面比较研究。志愿者被分为三组：肠热症组（n = 32）、急性胰腺炎组（n = 30）和健康对照组（n = 31）。使用标准问卷收集参与者的社会人口统计学和临床信息。采集血液和粪便样本，随后进行生化分析：总淀粉酶、脂肪酶、胰腺淀粉酶、血清弹性蛋白酶1、肝酶、钙、镁、磷酸盐、粪便颜色、粪便pH值和粪便脂肪含量。
与肠热症组和对照组相比，急性胰腺炎组的总淀粉酶、脂肪酶、弹性蛋白酶-1、碱性磷酸酶、天冬氨酸转氨酶和γ-谷氨酰转移酶水平更高（P均<0.05）。发现所有急性胰腺炎参与者的弹性蛋白酶1水平都很高，而肠热症组未观察到升高。在急性胰腺炎组和肠热症组中，脂肪酶与总淀粉酶之间均存在正相关（ρ = 0.543，P = 0.001；两者均为ρ = 0.543，P = 0.001）。
发现总/胰腺淀粉酶和脂肪酶水平升高表明患者患有急性胰腺炎和肠热症。此外，发现弹性蛋白酶-1是区分急性胰腺炎和肠热症的良好生物标志物。
