King L G, Seelig C B, Ranney J E
Department of Internal Medicine, New Hanover Regional Medical Center, Wilmington, North Carolina.
Am J Gastroenterol. 1995 Jan;90(1):67-9.
The ratio of serum lipase to serum amylase has been proposed to distinguish acute episodes of alcoholic from nonalcoholic pancreatitis. We evaluated the efficacy of this test in a community hospital setting.
Charts of all patients discharged with a diagnosis of acute pancreatitis over 19 months were retrospectively reviewed. Patients were excluded if their creatinine was greater than 3.0 mg/dl, if the amylase and lipase were not measured within 72 h of the onset of symptoms, or if the cause of pancreatitis was not known by the time of discharge.
Of the 56 patients, 31 had alcoholic pancreatitis. The lipase to amylase ratio did not differ significantly between patients with alcoholic and nonalcoholic pancreatitis. Median amylase and lipase were significantly higher in nonalcoholic pancreatitis; however, the wide ranges of both meant that neither amylase nor lipase accurately determined the cause of pancreatitis.
The lipase to amylase ratio does not appear to be sufficiently sensitive or specific to distinguish alcoholic from nonalcoholic acute pancreatitis.
有人提出血清脂肪酶与血清淀粉酶的比值可用于区分酒精性胰腺炎和非酒精性胰腺炎的急性发作。我们评估了该检测方法在社区医院环境中的有效性。
回顾性分析了19个月内所有诊断为急性胰腺炎出院患者的病历。如果患者的肌酐大于3.0mg/dl、淀粉酶和脂肪酶在症状发作后72小时内未检测、或出院时胰腺炎病因不明，则将其排除。
56例患者中，31例患有酒精性胰腺炎。酒精性胰腺炎和非酒精性胰腺炎患者的脂肪酶与淀粉酶比值无显著差异。非酒精性胰腺炎患者的淀粉酶和脂肪酶中位数显著更高；然而，两者的广泛范围意味着淀粉酶和脂肪酶都不能准确确定胰腺炎的病因。
脂肪酶与淀粉酶的比值似乎不足以敏感或特异地区分酒精性和非酒精性急性胰腺炎。
