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各種外科的 疾患에 있어서의 血中 Amylase 値의 臨床的 考察

The Clonical Studies of Serum Amylase Levels in Acute Abdomen , Acute Trauma , Renal Insufficiency and Hepatopathy

대한외과학회지 1964년 6권 10호 p.607 ~ 613
이병화,
소속 상세정보
이병화 (  ) - 서울대학교 의과대학 외과학교실

Abstract


The determination of serum amylase activity has been the most useful single laboratory aid for the acute pancreatitis. It is generally accepted that extrapancreatic causes of hyperamylasemia are intestinal obstruction, penetrating or peforating peptic ulcer and renal insufficiency, as well as acute disease of the salivary gland.
The elevation of serum amylase level has been also observed in physical stress such as traumas and major surgery.
In this paper we presented a finical study of a total of 230 patients including 138 cases of acute abdomen, 42 cases of acute trauma, 28 cases of liver disease and 22 cases of renal insufficiency.
The results are as follows:
Ⅰ. In 103 cases of acute abdomen other than 35 cases of acute pancreatitis:
1) 5(27%) cases out of 18 cases of iutestinal obstruction showed an elevated serum amylase level, ranging from 182 to 462 Somogyi units.
2) 3(30%) of 10 cases of penetrating or peforating peptic ulcer showed an elevated level with 185, 315 and 475 units.
3) 2(16%) of 12 cases of acute billiary disease showed an elevated level with 180 and 285 units.
4) 2(16%) of 12 cases of P.I.D. showed an elevated level with 188 and 365 units.
5) 5(9%) of 51 cases of acute appendicitis showed ane levated level ranging from 185 to 365 units.
The results were obtained within the 2nd hospital day. In 7 of 52 cases of surgical intervention an elevation of amylase level was proved postoperatively, with the range of 182 to 315 units.
Ⅱ. 8(18%) of 42 cases of Acute trauma revealed an elevated serum amylase level ranging from 180 to 317.5 units.
Ⅲ. 4(18%) of 22 cases of renal insufficiency revealed an elevated serum amylase level ranging from 180 to 264 units.
Ⅳ. In hepatopathy, on the contrary, 6(21%) of 28 cases were proved a decreased serum amylase level of 60 to 15 units.
It appears that the incidence or the degree of increase or decrease of serum amylase level depends partly upon the extensiveness or intensiveness of the disease.
From this study it might be induced a conclusion that the serum amylase level can be influenced by a number of factors, and its clinical application must not be achieved with the same popularity as previous single determination, yet it would be rather indicated for determining prognosis in some extrapancreatic diseases.

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