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The Influencing Factors and Diagnostic Value of Lipase, Amylase and Lipase/Amylase Ratio in Acute Pancreatitis

Author: HuZhiGang
Tutor: GuoXiaoZhong
School: Dalian Medical University
Course: Internal Medicine
Keywords: acute pancreatitis lipase amylase logistic regression analysis
CLC: R576
Type: Master's thesis
Year: 2013
Downloads: 15
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Abstract


Objective: Serum lipase (LPS), amylase (AMY) and lipase/amylase ratio (L/A)in acute pancreatitis were investigated their positive diagnosis rate and correlation withthe gender, etiology, age, onset time, severity, and CT performance of the patientsfactors.The establishment of logistic binary regression model were used to determinethe severity of acute pancreatitis and provide evidence for future diagnosis andtreatment of acute pancreatitis.Methods:172patients with acute pancreatitis were admitted to our retrospectiveanalysis from January2006to September2010.Their LPS, AMY and L/A wereobtained. The gender was divided into male and female, the cause were divided into sixgroups, including biliary, alcohol, hyperlipidemia, confounding factors, diet,idiopathic.In addition, the cause also were divided into alcoholic, non-alcoholicgroup.In accordance with the APACHE-II score standard, age were divided into fivegroups, including <45years,45to54years,55to64years,65to74years,≥75years. Onset time were divided into four groups, including within24hours,24to48hours,48to72hours, more than72h.the condition were divided into light and heavy.OnCT performance, two group is divided into the exudative group and the non-exudativegroups.Statistical software SPSS18.0was used to analyse the difference of serum LPS,AMY and L/A among the groups and the positive diagnosis rate of LPS and AMY. Alogistic regression model was established to determine the severity of the patients withacute pancreatitis.Results: In terms of gender, serum LPS and AMY of male was less than women,and the difference was statistically significant. The positive diagnosis rate of LPS washigher than amylase. Among the groups in the etiology, the difference of LPS was not statistically significant. Except for gallstone patients, amylase of confounding groupwas significantly higher than the other groups. Serum LPS, AMY and L/A of alcoholicpatients had no significant difference with non-alcoholic patients. In terms of age, serumLPS of the first group was significantly greater than the second group and the fifthgroup. Serum AMY of the first group was significantly greater than the fourth groupand the fifth group. These differences were statistically significant. The positivediagnosis rate of LPS were82.8%,79.4%,93.9%,80%,90.5%, respectively.thepositive diagnosis rate of AMY were53.1%,52.9%,51.5%,65%,66.7%, respectively.The positive diagnosis rate of AMY is lower than that of LPS. In terms of onset day, thedifferences of Amy and LPS of other three groups were statistically significantcompared to the first group. The positive diagnosis rate AMY in each group were68%,55%,28.6%,32.1%, respectively. The positive diagnosis rate LPS were91.3%,70%,76%,78.6%, respectively. The difference of second group between AMY and LPS wasnot statistically school. Qther difference of each group was statistical difference. Interms of severity, LPS, AMY and L/A of the two groups had no statistically difference,positive diagnosis rate of light patients with51.9%,68%, heavy patients were68.3%,85.3%.The difference between light and heavy was statistically significant. In terms ofCT performance, LPS between the two groups had no statistically difference, thedifference of AMY and L/A has statistical significance. The positive diagnosis rate ofAMY, LPS of exudation group were85.3%and91.2%, respectively. non-exudativegroup were33.3%,83.3%, the difference of AMY was statistically significant. If the L/A threshold is defined as≥5, positive diagnosis rate (66.7%) of non-exudative wassignificantly higher than that of exudative group (35.3%). By logistic binary regressionmodeling, we found that LPS, L/A and onset time comsisted of the regression model.Conclusions:1、LPS of acute pancreatitis may be related to gender, age and onset time of thepatients.2、 AMY had certain relation with gender, age, etiology, onset time, CTperformance of the patients with acute pancreatitis.3、The L/A ratio may be related to onset time and CT performance.The greater theL/A ratio, the smaller the possibility of pancreatic exudate.4、The influencing factors of severity of acute pancreatitis included LPS, L/A andonset time.

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CLC: > Medicine, health > Internal Medicine > Digestive and abdominal diseases > Pancreatic diseases
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