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概要

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• Recently, ACCR has been widely used for diagnosis of acute pancreatitis. In this report, fundamental studies were performed to evaluate clinical significance of ACCR.Since blue starch method gave falsely lower values than the actual ones of urinary amylase, accurate value of ACCR can be obtained by the addition of albumin to urine in order to increase the protein concentration. ACCR can be calculated by simple method instead of one hour clearance method.Although ACCR was presented as the method by which influence of impaired renal function on amylase clearance could be eliminated, increased ACCR were observed in patients with renal insufficiency having under Ccr 60 mi/min.In patients with acute pancreatitis, diurnal variance of ACCR is not large while daily variance of its is remarkable. Frequent measurement of ACCR is required, because each patient shows different curve. Most elevated values of ACCR were seen in patients with pancreatic diseases, especially acute pancreatitis. ACCR is sometimes within normal range in patients with pancreatitis. However, increased ACCR suggests high possibility of acute pancreatitis.Increased ACCR cannot be seen in cases of hyperamylasemia induced by liver diseases, salivary gland disease, or unknown etiology.These results suggest that the ACCR is useful for the differential diagnosis of hyperamylasemia and for acute pancreatitis, and ACCR is valuable as well as clinical symptoms, serum amylase level, and urinary amylase output when diagnosing acute pancreatitis.

• 財団法人 日本消化器病学会の論文

著者

• 柴田 泉

  東京女子医大消化器内科

関連論文

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