血清脂肪酶对急性胰腺炎的诊断价值探讨
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摘要
目的:探讨血清脂肪酶(LPS)水平对急性胰腺炎(AP)的诊断价值。方法:选取急性腹痛患者294例,按病因分为非AP组、AP组,AP组分为胆源性组、酒精性组、高脂血症性组、特发性组及其他组。比较分析各组间LPS水平的变化;LPS水平与AP不同病因的关系;LPS、血清淀粉酶(S-AMY)对AP诊断效价的差异;并分析年龄、性别、吸烟史、饮酒史、TG与LPS的关系。结果:AP组S-AMY和LPS明显高于非AP组(P<0.001)。AP组中各种不同病因组的LPS均值均超过正常上限的3倍。当LPS超过正常上限2倍时对AP的诊断效价较高。饮酒与否与LPS水平相关(P<0.05),而年龄、性别、吸烟、TG则与LPS无关(P>0.05)。结论:AP组S-AMY、LPS水平均明显高于非AP性腹痛组;在AP的不同病因中LPS值变化不大;LPS对AP的诊断效价高于S-AMY;饮酒与否对LPS水平可能存在一定的影响。
Objective:To realize the value of serum lipase in the diagnosis of acute pancreatitis.Methods:294 of patients with acute abdominal pain,who were divided into AP group and non-AP group, and the AP group was further divided into biliary group, alcohol group,hyperlipidemia group, idiopathic group and other causes group.Analyzing levels of serum lipase between AP group and non-AP group, relationship between level of serum lipase and AP,difference of serum lipase and amylase in diagnosing AP,level of serum lipase of AP with different causes and the impaction about age, gender,smoking history,drinking history,triglyceride and serum lipase.Results:The levels of serum amylase and lipase of AP group were significantly higher than non-AP group.The mean level of serum lipase in different causes of AP group were more than 3 times of the upper limit of the normal range,significantly the gallstone group. It had a higher diagnostic titer of AP when serum lipase was more than 2 times of the upper reference limit of the normal range. But the difference between the groups was not statistically significant(P>0.05).There was a linear regression between the drinking history and serum lipase levels(P<0.05).However,the age,gender,smoking history and triglyceride levels had not(P>0.05).Conclusion:The levels of serum lipase and amylase in AP group were significantly higher than non-AP abdominal pain group.The serum lipase did not change among different causes of AP group significantly.The diagnostic titer of serum lipase to AP was higher than serum amylase. There may be a certain impact between the history of alcohol consumption and serum lipase level.
Objective:To realize the value of serum lipase in the diagnosis of acute pancreatitis.Methods:294 of patients with acute abdominal pain,who were divided into AP group and non-AP group, and the AP group was further divided into biliary group, alcohol group,hyperlipidemia group, idiopathic group and other causes group.Analyzing levels of serum lipase between AP group and non-AP group, relationship between level of serum lipase and AP,difference of serum lipase and amylase in diagnosing AP,level of serum lipase of AP with different causes and the impaction about age, gender,smoking history,drinking history,triglyceride and serum lipase.Results:The levels of serum amylase and lipase of AP group were significantly higher than non-AP group.The mean level of serum lipase in different causes of AP group were more than 3 times of the upper limit of the normal range,significantly the gallstone group. It had a higher diagnostic titer of AP when serum lipase was more than 2 times of the upper reference limit of the normal range. But the difference between the groups was not statistically significant(P>0.05).There was a linear regression between the drinking history and serum lipase levels(P<0.05).However,the age,gender,smoking history and triglyceride levels had not(P>0.05).Conclusion:The levels of serum lipase and amylase in AP group were significantly higher than non-AP abdominal pain group.The serum lipase did not change among different causes of AP group significantly.The diagnostic titer of serum lipase to AP was higher than serum amylase. There may be a certain impact between the history of alcohol consumption and serum lipase level.
引文
[1] 中华医学会消化病学分会胰腺疾病学组.中国急性胰腺炎诊治指南(草案)[J].中华内科杂志.2004,24(3):190.
[2] Cornett DD,Spier BJ,Eggert AA,et al.The causes and outcome of acute pancreatitis associated with serum lipase>10,000 u/l[J].Dig Dis Sci,2011,56(11):3376-3381.
[3] Volz KA,McGillicuddy DC,Horowitz GL,et al.Eliminating amylase testing from the evaluation of pancreatitis in emergency department[J].West J Emerg Med,2010,11(4):344-347.
[4] 王燕,郭婧澜,常欧.血清淀粉酶和脂肪酶联合检测在急性胰腺炎诊断中的应用[J].国际检验医学杂志,2014,35(3):265-266.
[5] 秦学军.血清淀粉酶和脂肪酶联合测定在急性胰腺炎诊断中的意义[J].中国实用医药,2013,8(7):44-45.
[6] 刘静,刘深建,王燕,等.单纯血清脂肪酶水平升高的病因分析[J].山东医药,2015,55(3):48-49.
[7] Steinberg GR,Kemp BE,Watt MJ.Adipocyte triglyceride lipase expression in human obesity[J].Am J Physiol Endocrinol Metab,2007,293(4):958-964.
[8] 刘军,赵冬,刘静,等.基因多态性对血浆脂蛋白脂肪酶浓度及甘油三酯水平的影响[J].中华医学杂志,2005,85(19):1339.
[2] Cornett DD,Spier BJ,Eggert AA,et al.The causes and outcome of acute pancreatitis associated with serum lipase>10,000 u/l[J].Dig Dis Sci,2011,56(11):3376-3381.
[3] Volz KA,McGillicuddy DC,Horowitz GL,et al.Eliminating amylase testing from the evaluation of pancreatitis in emergency department[J].West J Emerg Med,2010,11(4):344-347.
[4] 王燕,郭婧澜,常欧.血清淀粉酶和脂肪酶联合检测在急性胰腺炎诊断中的应用[J].国际检验医学杂志,2014,35(3):265-266.
[5] 秦学军.血清淀粉酶和脂肪酶联合测定在急性胰腺炎诊断中的意义[J].中国实用医药,2013,8(7):44-45.
[6] 刘静,刘深建,王燕,等.单纯血清脂肪酶水平升高的病因分析[J].山东医药,2015,55(3):48-49.
[7] Steinberg GR,Kemp BE,Watt MJ.Adipocyte triglyceride lipase expression in human obesity[J].Am J Physiol Endocrinol Metab,2007,293(4):958-964.
[8] 刘军,赵冬,刘静,等.基因多态性对血浆脂蛋白脂肪酶浓度及甘油三酯水平的影响[J].中华医学杂志,2005,85(19):1339.