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The diagnosis of pancreatic disease can be and often is most difficult, especially by means of amylase determination in serum and urine alone, so that it is necessary to add several related parameters to it.Diagnostic value and clinical significance on parameters obtained by two-hour's clearance methods were investigated in 50 normal subjects and 206 patients with pancreatic and various disorders.Serum amylase, Cam, Cam/Ccr, the urinary amylase excretion per hour (u-amylase output) and the ratio of urinary amylase to creatinine concentration (u-am/cr) were effective to the diagnosis of acute pancreatitis and the observation of its clinical course, and especially u-am/cr was most sensitive indicator for acute pancreatitis.Increased Cam and Cam/Ccr were not specific for acute pancreatitis, on the contrary, decreased Cam and Cam/Ccr had a diagnostic value for macroamylasemia with normal renal function.Isoenzyme assay of amylase may be helpful for definitive diagnosis of acute pancreatitis and macroamylasemia, and further more in advanced stage of chroinc pancreatitis. Clinical significance of amylase isoenzyme clearance, which increased frequently in various disorders, is not clear.
- 財団法人 日本消化器病学会の論文