Question 2: Is there any other reason for high amylase besides pancreas? Pancreas is the most important digestive gland in human body, which secretes pancreatic amylase, pancreatic lipase and pancreatic protein
enzyme, and enters into the small intestine to promote the digestion and absorption of food. In diseases such as pancreatitis, pancreatic amylase enters the bloodstream and is excreted in the urine due to inflammation of the pancreatic
tissues, resulting in elevated amylase in the patient's blood
and amylase in the urine. Thus, blood and urine amylase tests are one of the most important tools to help
doctors diagnose diseases such as pancreatitis.
In the emergency room came a 40-year-old male patient, in addition to a slightly high blood pressure body
health, a day to the epigastric colic-like pain, vomiting, vomiting with the smell of alcohol meat. The internal medicine
doctor found that the patient's epigastric pressure and pain is obvious and muscle tension, almost can not hear the bowel sounds, blood
total white blood cells and neutrophilic classification are high, abdominal X-ray fluoroscopy to see the intestinal tube obvious flatulence, the CT
pancreas shape is no abnormality. 1 hour after the return of serum amylase measurement results, 720 units, a significant
elevated.
There was no doubt that the patient had inflammation in the abdominal cavity, but there was disagreement as to the cause. The internist thought it was pancreatitis because of the elevated serum amylase but could not explain why the pancreas was morphologically normal, while the consulting surgeon thought it was an acute abdomen, the cause of which was difficult to determine and the reason for the elevated serum amylase was unknown.
The patient was kept for treatment because of the different opinions. Because of the different opinions, the patient was left for treatment and observation. 3 hours later, the condition
did not improve, and then appeared to have blue lips, cold hands and feet, cold sweats, body temperature rose to 39 ℃, after
again abdominal fluoroscopy, confirmed that it is intestinal obstruction. The patient was successfully treated with anti-shock therapy and was quickly taken to the operating room.
Surgical findings: mesenteric vascular embolism causing intestinal obstruction with peritonitis and no pancreatic
abnormalities.
The patient was revived. For this case, the Department of Gastroenterology held a special seminar on "Elevated serum and urinary amylase", and Professor Li made a central speech, saying:
Elevated serum amylase is an important condition for the diagnosis of acute pancreatitis, but there are many other variations.
This has been confirmed by many years of clinical experience and is particularly diagnostic when measured values are more than four times normal
. However, serum amylase is not elevated in 100% of patients with acute pancreatitis. Even if it is elevated, the degree of elevation is not parallel to the severity of the disease; in severe (hemorrhagic necrotic)pancreatitis, serum amylase is normal or lower than normal due to the excessive destruction of pancreatic tissues; and secondly, when measured 2-3 days after the onset of the disease, the amylase that had been increased is excreted by the kidneys,
and the amylase that had been increased by the kidneys is not normal.
Serum amylase can be normal when measured 2 to 3 days after the onset of the disease, when the original increase in amylase is excreted from the kidneys, and the value of serum amylase can be normal, and the value of urinary amylase will be elevated at this time; furthermore
Patients with elevated lipids can interfere with amylase measurement and make the measurement value not high.
Elevated serum amylase is not always pancreatitis. There are a number of diseases that are clinically similar to pancreatitis, and serum amylase can be elevated, such as perforated peptic ulcers, appendicitis, intestinal obstruction,
myocardial infarction, ectopic pregnancy, and mesenteric artery embolism, etc., which the doctor must carefully
differentiate, and do some special tests accordingly.
I have met a 65-year-old female foreign teacher who was diagnosed with hemorrhagic pancreatitis before her death, and was diagnosed with a ruptured aneurysm of the coarctation of the abdominal aorta after autopsy.
The patient had to be treated for a rupture of the aneurysm.
Another large group of diseases also have elevated serum amylase, but the clinical manifestations are completely different from those of acute pancreatitis and are easier to distinguish, such as mumps, parotid tumors, pancreatic cancer, peripelvic carcinoma,
ovarian tumors, salpingitis, acute and chronic renal failure, post-abdominal surgery, post-cardiac surgery, ketoacidosis, and intravenous adrenocorticotropic hormones (e.g., hydrocortisone, oxycodone, and other medications). (e.g., hydrocortisone, dexamethasone).
Serum amylase comes from different sources. The body's "main factory" for making amylase is the pancreas, and when the pancreas is damaged, the "product" leaks into the bloodstream and blood amylase levels rise.
The salivary gland also produces a certain amount of amylase, usually we chew rice or steamed bread for a long time in the mouth,
the longer the more sweet is the salivary amylase hydrolysis of starch in the food to glucose.
Usually measured serum amylase is the sum of these two amylases, each accounting for 50%. If serum amylase is elevated and the source is unknown, more precise immunoelectrophoresis can be used to distinguish the source.
Sometimes the absolute amount of amylase in the blood is not much, only because of kidney disease, amylase can not be normally
discharged, and thus accumulated in the blood, like a constant amount of water into the pool and drainage is not good, the pool
in the water will also be more, which is the reason for the elevation of serum amylase in some renal diseases.... >>
Question 3: What causes high amylase Amylase is a digestive enzyme secreted by the pancreas to promote absorption, and the assay can be categorized into blood amylase and urinary amylase, of which blood amylase is more accurate. If the pancreas has a disease can be increased, but some other diseases can also be mildly increased, but slightly increased should not be a big problem! You just have to eat regularly, not overeat, and especially not drink alcohol! Because drinking alcohol can directly *** pancreas secretion of amylase!
Question 4: What is the disease of high amylase, and what causes can be caused Disease Analysis:
Hello, according to your description of the situation, consider the possibility of pancreatitis.
Guidance:
Hello, according to the above analysis, it is recommended to go to the hospital in time, timely treatment, pay attention to rest.
Question 5: What is the matter with high amylase Elevated amylase in pancreatitis