Clinical application of pancreatic amylase and lipase in acute pancreatitis

Objective To investigate the clinical value of pancreatic amylase (P-AMY) in acute pancreatitis,and perform methodical evaluation on total amylase (α-AMY),P-AMY and lipase.Methods 126 cases of patients with acute pancreatitis,105 cases of disease controls and 95 healthy controls were involced in the investigation. Hitachi7600 automatic biochemical analyzer was applying to measuring α-AMY,P-AMY and lipase. The upper limit of the reference range of the total amylase,pancreatic amylase and lipase was 216 U/L,115 U/L and 200 U/L respectively in our laboratory.Results The sensitivity of total amylase,pancreatic amylase,and lipase for the diagnosis of acute pancreatitis was 73.1%,88.5% and 92.3% respectively; and while the specificity was 70.5%、81.9% and 82.9% respectively. The diagnostic accuracy,determined as the area under the curve,was 0.795 for total amylase,0.868 fos pancreatic amylase,and 0.886 for lipase. There was a significant difference between the total amylase and pancreatic amylase (P=0.045),but no significant difference was found between the pancreatic amylase and lipase (P=0.613) by ROC curve.Conclusion Pancreatic amylase has a higher sensitivity,specificity and diagnostic accuracy than α-AMY in acute pancreatitis,and shows a similar diagnostic performance as lipase. Therefore,P-AMY and lipase should be measured in combination in the diagnosis of acute pancreatitis.