急性胰腺炎患者血淀粉酶变化和CT诊断的比较

Comparative study between serum amylase and CT grades in patients with acute pancreatitis

目的探讨血淀粉酶的变化规律及其机制。方法本研究对确诊的172例急性胰腺炎(AP)患者随机分为3组,分别在发病≤12 h、12～24 h、48～72 h行CT和血淀粉酶检查。分析不同时间段CT和血淀粉酶检出率。结果 87.5%患者血淀粉酶在6～12 h升高;100%患者血淀粉酶在12 h以上升高。91.3%的患者在12～24 h之间CT检查发现胰腺炎症变化,但与发病大于48 h相比,无显著差异。12 h之内,血淀粉酶升高的阳性率高于CT诊断的阳性率(χ2=22.04,P<0.01)。48～72 h D级、E级检出率明显高于12 h之内和12～24 h之间的检出率。血淀粉酶随着轻症急性胰腺炎分级水平有上升趋势;随着重症急性胰腺炎分级水平有下降趋势。结论血淀粉酶升高的水平与胰腺炎的病情程度无明显相关性,推测其机制可能与胰腺微循环受损程度有关。

Objective To investigate the relationship between serum amylase and CT scan in patients with acute pancreatitis（AP）. Methods CT examination and serum amylase in patients with AP were executed respectively within 12 hours＇ span,12 to 24 hours＇ span,24 to 72 hours＇ span. Results Serum amylase elevated within 6 to 12 hours in 87.5% patients;100% patients elevated after 12 hours.CT manifestations of pancreatitis from 12 to 24 hours were found in 91.3% patients.The positive rate of serum amylase was higher significantly than that of CT within 12 hours.Serum amylase value of mild acute pancreatitis gradually rised,while that of severe acute pancreatitis had decreased along with their grades. Conclusion There is no correlation between the level of serum amylase and the severity of acute pancreatitis.Serum amylase is better in early diagnose of AP compared to CT.