Bouwman D L, Weaver D W, Walt A J
J Trauma. 1984 Jul;24(7):573-8.
Previous reports on the use of the serum amylase level to assess pancreatic injury in patients with blunt abdominal trauma have been disappointing. The availability of methods to measure the serum isoamylases (P & NP) might be expected to improve the accuracy with which the serum amylase level is used. Sixty-one patients treated for a variety of blunt trauma injuries were studied. All categories of injury were included. Isoamylase levels were determined from admission sera and were compared to injuries found at laparotomy. Three patients had major pancreatic injury but only two of these patients showed a rise in the pancreatic isoamylase. Sixteen additional patients had a rise in the pancreatic isoamylase without evidence of pancreatic injury. Eight of these patients had no component of abdominal injury whatsoever. Two patients with isolated head injury had substantial elevations of pancreatic isoamylase. The regulation of serum amylase is multifactorial and variable. The measurement of serum isoamylase levels does not offer great improvement over the serum amylase in evaluating patients with blunt abdominal trauma.
先前有关利用血清淀粉酶水平评估钝性腹部创伤患者胰腺损伤情况的报告并不令人满意。人们原本期望，能够测量血清同工淀粉酶（P型和NP型）的方法可以提高血清淀粉酶水平检测的准确性。对61例因各种钝性创伤而接受治疗的患者进行了研究。纳入了所有类型的损伤。从入院时的血清中测定同工淀粉酶水平，并将其与剖腹手术中发现的损伤情况进行比较。有3例患者存在严重胰腺损伤，但其中只有2例患者的胰腺同工淀粉酶水平升高。另有16例患者的胰腺同工淀粉酶水平升高，但并无胰腺损伤的证据。这些患者中有8例根本没有腹部损伤的成分。2例单纯头部受伤的患者胰腺同工淀粉酶水平大幅升高。血清淀粉酶的调节是多因素且多变的。在评估钝性腹部创伤患者时，测量血清同工淀粉酶水平相比血清淀粉酶并无显著改善。
