84例淀粉酶升高的常见腹部疾病临床分析.docxVIP

第 第 PAGE 1 页 共 NUMPAGES 1 页 84例淀粉酶升高的常见腹部疾病临床分析 [摘要] 目的:探讨常见腹部疾病血清淀粉酶水平及其升高可能的原因及临床意义。方法:对84例以腹部症状就诊,伴有血清淀粉酶升高的患者进行归类和回顾性分析。结果:胰腺炎21例(25%),2～12 h、12～24 h血淀粉酶分别为(465.1±211.4)、(509.1±89.9)U/L。非胰源性疾病:胆囊炎25例(29.7%)、急性腹膜炎14例(16.6%)、急性阑尾炎11例(13.7%)、肠梗阻8例(9%)、溃疡病5例(6%),非胰源性疾病2～12 h、12～24 h血淀粉酶分别(381.9±67.7)、(293.4±64.7)U/L。结论:除胰源性淀粉酶升高外,许多腹部疾病均可引起淀粉酶升高。鉴别胰源性与非胰源性淀粉酶升高具有重要意义。  [关键词] 淀粉酶;腹部疾病;鉴别诊断  [中图分类号] R656.1[文献标识码]A[文章编号]1673-7210(2009)07(c)-021-02  Clinical analysis of 64 cases of common abdominal diseases with heighten amylase  LI Xilin  (Zhongyuan Oil Field Hospital of Puyang City, Puyang 457164,China)  [Abstract] Objective: To investigate the amylase level of common abdominal diseases,and analyze both possible cause and clinic significance of those diseases with high amylase level. Methods: The clinical data of 84 cases of abdominal diseases with high level amylase were classified and retrospectively analyzed. Results: 21 cases of pancreatitis(25%),25 cases of cholecystitis(29.7%),14 cases of pyoperitonitis(16.6%),5 cases of digestive ulcer(6%),11 cases of acute appendicitis(13.7%),8 cases of bowel obstruction(9%), amylase level of 2-12 h, 24-48 h of pancreatitis group was (465.1±211.4), (509.1±89.9) U/L respectively; that of non-pancreatitis group was (381.9±67.7),(293.4±64.7) U/L respectively. Conclusion: Besides pancreatitis, many other abdominal disease can also lead to levels of serum amylase heighten, it is significant to identify the pancreatic and non-pancreatic disorders.  [Key words] Amylase; Abdominal diseases; Differential diagnosis  以腹部症状就诊的患者中,血清淀粉酶升高并不仅仅见于胰腺疾病,许多腹部非胰腺性疾病的淀粉酶也会升高,个别病例的淀粉酶升高还较明显。临床上,鉴别胰腺疾病与非胰源性淀粉酶升高性疾病具有重要意义。本文就常见腹部疾病的血清淀粉酶升高情况及可能的机制进行探讨。  1 资料与方法  1.1 一般资料  2004～2007年,在我院就诊的84例患者。其中,男46例,女38例;年龄15～87岁,平均39.6岁。  1.2 病例选择与排除  病例选择:以腹部症状就诊的患者中,血清淀粉酶升高,结合血常规、生化、腹部CT 或B 超检查诊断明确者。病例排除:资料不全、转院后失访、诊断不明者。  1.3 方法  在发病2～12 h、24～48 h内,检测血胰淀粉酶。检验方法应用美国强生公司干化学反应设备测定血胰淀粉酶。  1.