Dickson A P, O'Neill J, Imrie C W
Br J Surg. 1984 Sep;71(9):685-8. doi: 10.1002/bjs.1800710913.
Of 311 patients with primary acute pancreatitis, seven revealed major and seven minor lipid abnormalities on hospital admission. One pregnant woman suffered acute pancreatitis associated with Fredrickson type I hyperlipoproteinaemia. Twelve of the 13 men with types IV and V hyperlipoproteinaemia suffered alcohol abuse pancreatitis and represented 13.2 per cent of this aetiological group. However, only one of the 157 patients (0.6 per cent) with biliary disease had lipid abnormalities. Two of the 13 men died--the oldest, who had gallstones, and one with alcohol related disease. The remaining 11 were subject to follow-up (5-10 years). Six, who had improvement of their lipid abnormalities, had abstained from alcohol. The other five had a persistent lipid disorder, and all admitted continuing heavy alcohol ingestion. The clinical diagnosis of acute pancreatitis was supported by serum amylase elevation in only nine of the fourteen patients. Urinary amylase levels were consistent with the diagnosis in 11 of the 12 patients. Estimation of both serum and urinary amylase gave 100 per cent support to the clinical diagnosis of acute pancreatitis. Hyperlipidaemia associated with acute pancreatitis may be secondary to alcohol abuse but the possible role of HLP cannot be discounted. Urinary amylase is useful in diagnosing acute pancreatitis in the presence of hyperlipidaemia.
在311例原发性急性胰腺炎患者中，7例入院时出现主要脂质异常，7例出现次要脂质异常。1例孕妇患急性胰腺炎并伴有弗雷德里克森I型高脂蛋白血症。13例IV型和V型高脂蛋白血症男性患者中有12例患有酒精性胰腺炎，占该病因组的13.2%。然而，157例胆道疾病患者中只有1例（0.6%）有脂质异常。13例男性中有2例死亡——年龄最大的患有胆结石，另1例患有酒精相关疾病。其余11例接受随访（5 - 10年）。6例脂质异常有所改善的患者已戒酒。另外5例脂质紊乱持续存在，且均承认持续大量饮酒。14例患者中只有9例血清淀粉酶升高支持急性胰腺炎的临床诊断。12例患者中有11例尿淀粉酶水平与诊断相符。血清和尿淀粉酶的测定对急性胰腺炎的临床诊断支持率达100%。与急性胰腺炎相关的高脂血症可能继发于酒精滥用，但高脂血症的可能作用也不能忽视。在存在高脂血症的情况下，尿淀粉酶对诊断急性胰腺炎有用。
