Lankisch P G, Petersen M, Gottesleben F
Department of Internal Medicine, Municipal Hospital of Lüneburg.
Z Gastroenterol. 1994 Apr;32(4):213-5.
Serum amylase, lipase and C-reactive protein (CRP) levels upon and CRP again within 72 hours after admission were estimated in 115 consecutive patients with acute pancreatitis and correlated with contrast-enhanced computed tomography (CT) results performed within 72 hours after admission and scored for morphological changes and necroses. Serum enzyme levels > or = 3 times the upper limit of normal and CRP levels > or = 10 times on admission and maximal CRP levels > or = 10 times within 72 hours after admission significantly correlated with severe pancreatic morphological changes. Thus, contrary to previous belief, high, not low, enzyme levels indicate severe acute pancreatitis. Furthermore, maximal CRP levels > or = 10 times the upper limit of normal within 72 hours in all patients and amylase admission levels of > or = 3 times the upper limit of normal in alcoholics were significantly indicative of pancreatic necroses. Thus, serum enzyme estimation upon, and maximal CRP levels within 72 hours after, admission may help the clinician to evaluate the severity of acute pancreatitis when imaging procedures are not immediately available.
对115例连续的急性胰腺炎患者测定了入院时的血清淀粉酶、脂肪酶和C反应蛋白（CRP）水平，并在入院后72小时内再次测定CRP水平，同时将这些水平与入院后72小时内进行的对比增强计算机断层扫描（CT）结果相关联，并对形态学变化和坏死情况进行评分。血清酶水平≥正常上限的3倍、入院时CRP水平≥正常上限的10倍以及入院后72小时内最大CRP水平≥正常上限的10倍与严重的胰腺形态学变化显著相关。因此，与以往的观点相反，酶水平高而非低表明是严重的急性胰腺炎。此外，所有患者入院后72小时内最大CRP水平≥正常上限的10倍以及酗酒者入院时淀粉酶水平≥正常上限的3倍显著提示胰腺坏死。因此，当无法立即进行影像学检查时，入院时的血清酶测定以及入院后72小时内的最大CRP水平可能有助于临床医生评估急性胰腺炎的严重程度。
