Boddie D E, Couper G W, Watson H, Cooper G G
Department of Surgery, University of Aberdeen, UK.
J R Coll Surg Edinb. 1998 Oct;43(5):306-7.
Hyperamylasaemia may occur following abdominal aortic aneurysm rupture and its use as a prognostic indicator has been suggested. However, the isoenzyme responsible for the rise in serum amylase has not been investigated. In this study, isoenzyme analysis was performed on the serum of patients noted to have a raised amylase from their routine biochemistry samples. Individual cases were then reviewed regarding clinical course and outcome. The pancreas has been thought to be the predominant source of the observed hyperamylasaemia. However, in this study a mixed picture of pancreatic and salivary isoenzymes was found. Of the four highest recorded amylase levels two were salivary in origin, one pancreatic and one mixed. The highest recorded amylase level was of salivary origin in a patient that survived without any major complication. The four patients that died all showed evidence of gut infarction/ischaemia. Two had hyperamylasaemia of a mixed pattern, one pancreatic and one of salivary origin.
腹主动脉瘤破裂后可能会出现高淀粉酶血症，有人提出将其用作预后指标。然而，尚未对导致血清淀粉酶升高的同工酶进行研究。在本研究中，对常规生化样本中淀粉酶升高的患者血清进行了同工酶分析。然后对个别病例的临床病程和结果进行了回顾。胰腺一直被认为是观察到的高淀粉酶血症的主要来源。然而，在本研究中发现了胰腺同工酶和唾液同工酶的混合情况。在记录的四个最高淀粉酶水平中，两个起源于唾液，一个起源于胰腺，一个是混合性的。记录的最高淀粉酶水平来自一名存活且无任何重大并发症的患者，其起源于唾液。死亡的四名患者均有肠梗死/缺血的证据。两名患者的高淀粉酶血症呈混合模式，一名起源于胰腺，一名起源于唾液。
