淀粉酶、脂肪酶和C-反应蛋白检测对急性胰腺炎的诊断意义

Study on the role of amylase,lipase and C-reactive protein in the diagnosis of acute pancreatitis

目的探讨血清淀粉酶(AMY)、脂肪酶(LIP)和C-反应蛋白(CRP)早期诊断急性胰腺炎(AP)并估计其严重程度。方法选择32名重型AP患者(SAP组)、48名轻型AP患者(MAP组)、40名非胰腺炎急腹症患者(NAP组)以及38名健康体检者(正常对照组),测定血清AMY、LIP和CRP,比较其含量差别,计算AMY、LIP以及联合检测的灵敏度和特异度。结果除了MAP组和NAP组比较时CRP差异无统计学意义(P>0.05)外,其他各组间各指标比较时差异均有统计学意义(P<0.05)。血清AMY的敏感度88.75%,特异度92.3%;血清LIP的敏感度93.75%,特异度96.2%;联合检测AMY和LIP的敏感度97.5%、特异度91%。结论 AMY和LIP可用于AP的诊断与程度评估,CRP只能评估AP的严重程度。LIP诊断AP时优于AMY,两者联合检测可以提高敏感度。

Objective To investigate the role of amylase（ AMY）, lipase（LIP） and C - reactive protein（CRP） in the diagnosis and estimation of acute pancreatitis （AP）. Methods The serum levels of AMY, LIP and CRP were tested among the 32 serious acute pancreatitis（SAP） patients, 48 mild acute pancreatitis （MAP） patients, 40 non pancteatitis acute abdomen （NAP） pa- tients and 38 healthy persons, then the results were compared. The sensitivity and the specificity of AMY, LIP and joint detec- tion of AMY and LIP were tested after that. Results Compared the MAP group with the NAP group, CRP had no statistically significance （P 〉 0.05）. But the other items of the 2 group and all items of the other groups had statistical significance respec- tively （P 〈 0.05）. The sensitivity of AMY was 88.75%, and the specificity of AMY was 92.3%. The sensitivity of LIP was 93.75%, and the specificity of LIP was 96.2%. The sensitivity of joint detection of AMY and LIP was 97.5%, the specificity of joint detection was 91%. Conclusion AMY and LIP have significance in both of the diagnosis and severity of AP. CRP can only forecast the severity of AP. In the diagnosis of AP, LIP shows a better performance than AMY. The joint detection of AMY and LIP can improve the sensitivity in the diagnosis of AP.