What Is the Best Biochemical Test to Diagnose Acute Pancreatitis? A Prospective Clinical Study

摘要: Objective To determine which biochemical test is best to distinguish acute pancreatitis from other pancreatic and nonpancreatic diseases associated with hyperamylasemia. Design We conducted a prospective clinical study of 836 consecutive patients who had total serum amylase requested by physician during 7-month period. Material Methods Radioimmunoassay enzymatic activity methods were used measure pancreas-specific proteins varied size, charge, stability. In addition, scoring systems for the diagnosis pancreatitis, statistical analyses done sensitivity specificity. Results found minor differences in specificity among isoamylase, phospholipase A 2 , co- lipase, carboxylester lipase. Of these tests, combination isoamylase small but statistically significant increased (90%; 95% confidence interval [CI] = 74 98%) (93%; CI=91 95%) over (90% 92%, respectively; CI=90 94%) 75%, CI=72 78%) alone pancreatitis. Conclusion Pancreas-specific are satisfactory diagnosing if validated laboratory. Clinically, slight advantage using both does not outweigh expense performing two assays; we recommend diagnose