联合检测淀粉酶及脂肪酶对急性胰腺炎患儿的诊断价值

Clinical Value of Combined Detection of Amylase and Lipase in Diagnosis of Acute Pancreatitis in Children

目的探讨联合检测淀粉酶及脂肪酶对儿童急性胰腺炎的诊断价值。方法收集2010年1月-2012年6月湖南省儿童医院所有门诊及住院的急性胰腺炎患儿39例,并随机选取同期就诊的非急性胰腺炎的急腹症患儿36例作为对照组,同期健康体检儿童107例以确定AMY及LIP参考范围。比较两组患儿AMY及LIP水平,分析两种指标单独及联合检测的诊断性能。结果两组患儿年龄、性别比例差异无统计学意义。两组急腹症患儿的发病年龄以3岁左右最常见;急性胰腺炎组的AMY及LIP水平高于非急性胰腺炎急腹症组(P<0.001)。AMY及LIP的联合检测具有较高的敏感性(97.4%)及阴性预测值(96.6%),且显著高于其单独检测。结论单独检测时,LIP的诊断特异性及准确性高于AMY;AMY及LIP的联合检测具有较高敏感性及阴性预测值,优于单独检测,对儿童急性胰腺炎的诊断及排除具有一定的应用价值。

Objective To explore the diagnostic value of combined measurement of amylase （AMY） and lipase （LIP） in acute pancreatitis （AP） among children. Methods The study included 39 children with AP （AP group） and 36 non AP children with acute abdominal disease （control group） hospitalized in the Children＇s Hospital of Hunan Province from January 2010 to June 2012; meanwhile, serum AMY and LIP levels were detected in 107 healthy children so as to determine the medical reference ranges. Serum AMY and LIP levels of the two groups were compared. Diagnostic performance of single marker detec- tion and combined detection of the two markers was evaluated. Results There was no statistically significant difference in age and proportion of gender between AP group and control group. The general age of the onset in the above - mentioned two groups was about 3 years old. Serum AMY and LIP levels of AP group were higher than those of control group （P〈0. 001 ）. The sensi- tivity （97.4%） and negative predictive value （96.6%） of combined detection of AMY and LIP were significantly higher than those of single marker detection. Conclusions Diagnostic specificity and accuracy of LIP are higher than those of AMY when to use single marker detection. Combined detection of LIP and AMY shows higher sensitivity and negative predictive value, which is superior to single marker detection. It has certain application value in the diagnosis and exclusion of AP in children.