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目的探讨联合检测淀粉酶及脂肪酶对儿童急性胰腺炎的诊断价值。方法收集2010年1月-2012年6月湖南省儿童医院所有门诊及住院的急性胰腺炎患儿39例,并随机选取同期就诊的非急性胰腺炎的急腹症患儿36例作为对照组,同期健康体检儿童107例以确定AMY及LIP参考范围。比较两组患儿AMY及LIP水平,分析两种指标单独及联合检测的诊断性能。结果两组患儿年龄、性别比例差异无统计学意义。两组急腹症患儿的发病年龄以3岁左右最常见;急性胰腺炎组的AMY及LIP水平高于非急性胰腺炎急腹症组(P<0.001)。AMY及LIP的联合检测具有较高的敏感性(97.4%)及阴性预测值(96.6%),且显著高于其单独检测。结论单独检测时,LIP的诊断特异性及准确性高于AMY;AMY及LIP的联合检测具有较高敏感性及阴性预测值,优于单独检测,对儿童急性胰腺炎的诊断及排除具有一定的应用价值。
Objective To investigate the diagnostic value of combined detection of amylase and lipase in children with acute pancreatitis. Methods Thirty-nine children with acute pancreatitis from January 2010 to June 2012 in Hunan Children’s Hospital were enrolled. Thirty-six children with acute abdomen with non-acute pancreatitis were randomly selected as the control group, The same period, 107 children with healthy physical examination to determine the AMY and LIP reference range. The AMY and LIP levels in both groups were compared, and the diagnostic performance of the two indexes alone and in combination test was analyzed. Results There was no significant difference in age and sex between the two groups. The onset ages of children with acute abdomen were the most common at the age of 3 years. The levels of AMY and LIP in acute pancreatitis group were higher than those in acute non-acute pancreatitis group (P <0.001). The combined detection of AMY and LIP had higher sensitivity (97.4%) and negative predictive value (96.6%), which was significantly higher than that of single detection. Conclusions The specificity and accuracy of LIP in the diagnosis of acute pancreatitis were higher than that of AMY alone. The combined detection of AMY and LIP had higher sensitivity and negative predictive value than single detection, Value.