Salt W B, Schenker S
Medicine (Baltimore). 1976 Jul;55(4):269-89. doi: 10.1097/00005792-197607000-00001.
This review of the English literature on amylase was undertaken because no recent discussion of the subject could be located, no comprehensive list of disorders causing hyperamylasemia or hyperamylasuria is available, and several major advances in the area have been made, notably the amylase isoenzyme determination and Cam/Ccr ratio. Several important concepts have emerged from this review. First, hyperamylasemia and hyperamylasuria are not specific indices of the presence of pancreatic disease or damage. Second, serum and urinary amylase levels can be spuriously normal with hypertriglyceridemia and pancreatitis. Third, the current emphasis on diagnostic methods for measuring serum amylase isoenzymes promises to improve the specificity of this determination. It will also enhance our understanding of the sources, distribution, metabolism, and elmination of amylase. Fourth, the development of the Cam/Ccr ratio may provide a practical diagnostic tool for separating clinically significant hyperamylasemia due to pancreatitis from that caused by other factors. Both the the isoamylase determination and Cam/Ccr ratio clearly require future research to place their clinical application in the proper perspective.
之所以对淀粉酶的英文文献进行综述，是因为找不到近期关于该主题的讨论，没有导致高淀粉酶血症或高淀粉酶尿症的疾病的综合列表，而且该领域已经取得了几项重大进展，尤其是淀粉酶同工酶测定和Cam/Ccr比值。本次综述产生了几个重要概念。第一，高淀粉酶血症和高淀粉酶尿症并非胰腺疾病或损伤存在的特异性指标。第二，高甘油三酯血症和胰腺炎时血清和尿淀粉酶水平可能会假性正常。第三，目前对血清淀粉酶同工酶测量诊断方法的重视有望提高该测定的特异性。这也将增进我们对淀粉酶的来源、分布、代谢和清除的理解。第四，Cam/Ccr比值的发展可能为区分胰腺炎引起的具有临床意义的高淀粉酶血症和其他因素引起的高淀粉酶血症提供一种实用的诊断工具。淀粉酶同工酶测定和Cam/Ccr比值显然都需要未来的研究，以便正确看待它们的临床应用。
