丙氨酸和天冬氨酸转氨酶在特发性急性胰腺炎微石症诊断中的价值。

F Grau, P Almela, L Aparisi, D Bautista, I Pascual, A Peña, J M Rodrigo
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引用次数: 28

摘要

结论:血清转氨酶,尤其是谷丙转氨酶(ALT)升高提示特发性急性胰腺炎患者有微石症,尤其是在腹痛发作后早期评估时。背景:已有研究表明,生化实验室值仅是区分胆结石与非结石性急性胰腺炎的有用参数。我们评估了丙氨酸转氨酶(ALT)和天冬氨酸转氨酶(AST)对特发性急性胰腺炎隐匿性微石症的诊断价值。方法:对91例特发性急性胰腺炎患者行十二指肠刺激胆汁沉淀物镜检的资料进行回顾性分析。根据腹痛发作后ALT和AST检测的早发性,将患者分为两组:A组在发病前24 h内(n = 56), B组在发病24 ~ 72 h内(n = 35)。结果:胆道引流阳性A组患者ALT和AST的中位值(范围)分别为2.5 (0.1 ~ 18.1)vs 0.4(0.1 ~ 8.6)和3 (0.3 ~ 17.4)vs 0.5 (0.3 ~ 11.9), ALT和AST的中位值(以正常上限升高次数表示)高于b组。在单因素分析和受试者工作特征(ROC)曲线中,前24 h内ALT的敏感性为73%,特异性为86%,对于正常上限升高1.2的临界值,阳性预测值为92%。这些数值略高于AST(分别为73%、80%和89%),但无统计学差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Usefulness of alanine and aspartate aminotransferases in the diagnosis of microlithiasis in idiopathic acute pancreatitis.

Conclusion: Serum increases of aminotransferases, especially alanine aminotransferase (ALT), were suggestive of microlithiasis in idiopathic acute pancreatitis, particularly when assessed early after the onset of abdominal pain.

Background: It has been shown that biochemical laboratory values only are useful parameters in distinguishing gallstone from nongallstone acute pancreatitis. We assessed the diagnostic usefulness of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) for identification of occult microlithiasis in idiopathic acute pancreatitis.

Methods: Ninety-one patients with idiopathic acute pancreatitis who underwent microscopic examination of stimulated duodenal bile sediments were retrospectively studied. According to earliness of ALT and AST assay after the onset of abdominal pain, patients were divided into two groups: group A, within the first 24 h (n = 56) and group B, between 24 and 72 h (n = 35).

Results: ALT and AST values expressed as number of elevations of the upper limits of normal were higher in group A patients with positive biliary drainage than in group B. Median (range) ALT and AST values were 2.5 (0.1-18.1) vs 0.4 (0.1-8.6) and 3 (0.3-17.4) vs 0.5 (0.3-11.9), respectively. In the univariate analysis and receiver operating characteristic (ROC) curves, ALT within the first 24 h showed a sensitivity of 73%, specificity of 86%, and positive predictive value of 92% for a cutoff of 1.2 elevations of the upper limit of normal. These values were slightly higher, although without statistically significant differences, than those of AST (73, 80, and 89%, respectively).

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