Haffter D, Meyer N, Scholer A, Gyr K
Schweiz Med Wochenschr. 1983 Feb 5;113(5):184-8.
In a prospective study the value of serum amylase and serum lipase determination has been analyzed in 19 patients with an acute episode of acute or chronic pancreatitis and in 19 patients with acute abdomen not due to pancreatitis. The concentration of urinary amylase and the urinary output of amylase in the spot urine as well as after a two-hour collection period have also been examined. The normal values were determined in 21 healthy volunteers and the reproducibility of the various parameters was analyzed after 1 hour and 25 hours in these volunteers. For diagnosis of an acute episode of chronic pancreatitis serum amylase was found to have good sensitivity, but a specificity inferior to that of serum lipase. By contrast, the specificity of serum lipase is excellent. Unlike determination of serum enzymes, measurement of urinary enzymes in all variations does not offer any further advantage. Except for the combination of serum amylase and serum lipase, none of the other tested combinations provides further diagnostic information. The examination of spot urine samples is not inferior to the 2-hour urine specimen. For the time being the combination of serum amylase and serum lipase determination is again recommended for diagnostic routine in patients with an acute episode of pancreatitis.
在一项前瞻性研究中，对19例急性或慢性胰腺炎急性发作患者以及19例非胰腺炎所致急腹症患者的血清淀粉酶和血清脂肪酶测定值进行了分析。还检测了尿淀粉酶浓度以及即时尿和两小时收集期后的尿淀粉酶排出量。在21名健康志愿者中测定了正常值，并在这些志愿者1小时和25小时后分析了各项参数的可重复性。对于慢性胰腺炎急性发作的诊断，发现血清淀粉酶具有良好的敏感性，但特异性低于血清脂肪酶。相比之下，血清脂肪酶的特异性极佳。与血清酶的测定不同，各种情况下尿酶的测量没有任何进一步的优势。除了血清淀粉酶和血清脂肪酶的联合检测外，其他检测组合均未提供更多诊断信息。即时尿样本检测并不逊色于两小时尿标本。目前，对于胰腺炎急性发作患者的诊断常规，再次推荐血清淀粉酶和血清脂肪酶联合检测。
