BACKGROUND Despite widespread recommendations to favor lipase over amylase in the diagnosis and management of acute pancreatitis, many routine hospital laboratories still offer amylase testing. This study sought to evaluate and compare ordering patterns of amylase and lipase in patients with acute pancreatitis. METHODS We analyzed 438 patients with acute pancreatitis admitted to our hospital. Data collection included pancreatitis etiology and management as well as biochemical profiles of amylase and lipase. We compared serial ordering patterns, degree of biomarker elevation, and normalization kinetics. RESULTS All patients had at least one lipase ordered during their admission, and only 51 patients (12%) had at least one amylase ordered. On average, lipase was elevated 5 times higher above its respective upper reference limit than amylase at admission. Pancreatitis etiology was skewed toward gallstones in the amylase group as compared to the lipase only group (69% vs. 43%), and surgical patients (laparoscopic cholecystectomy) were more likely to have amylase ordered and/or trended. CONCLUSIONS Amylase measurement was not necessary in the diagnosis and management of 88% of patients with acute pancreatitis. Of patients for whom amylase was ordered, it was common for these patients to be those referred to surgical procedures, possibly because amylase normalization may be documented faster than that of lipase.

中文翻译：

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生物标志物在急性胰腺炎的诊断和治疗中的应用回顾表明，淀粉酶有序性在需要腹腔镜胆囊切除术的患者中受到青睐。

背景技术尽管在急性胰腺炎的诊断和管理中广泛推荐使用脂肪酶而不是淀粉酶，但是许多常规医院实验室仍提供淀粉酶测试。这项研究试图评估和比较急性胰腺炎患者淀粉酶和脂肪酶的订购方式。方法我们分析了438例入院的急性胰腺炎患者。数据收集包括胰腺炎的病因和治疗以及淀粉酶和脂肪酶的生化特征。我们比较了序列排序模式，生物标志物升高的程度和归一化动力学。结果所有患者入院时均订购了至少一种脂肪酶，只有51例患者（占12％）订购了至少一种淀粉酶。一般，脂肪酶在入院时比淀粉酶的参考上限高出5倍。与仅脂肪酶组相比，胰腺炎的病因偏向于淀粉酶组（69％比43％），并且手术患者（腹腔镜胆囊切除术）更有可能接受和/或倾向于淀粉酶治疗。结论在88％的急性胰腺炎患者的诊断和治疗中不需要淀粉酶检测。在订购了淀粉酶的患者中，通常将这些患者转诊至外科手术，这可能是因为淀粉酶正常化的记录时间可能比脂肪酶的记录速度要快。外科手术患者（腹腔镜胆囊切除术）更容易接受和/或倾向于淀粉酶治疗。结论88％的急性胰腺炎患者的诊断和治疗中无需使用淀粉酶。在订购了淀粉酶的患者中，通常将这些患者转诊至外科手术，这可能是因为淀粉酶正常化的记录时间可能比脂肪酶的记录速度要快。外科手术患者（腹腔镜胆囊切除术）更容易接受和/或倾向于淀粉酶治疗。结论在88％的急性胰腺炎患者的诊断和治疗中不需要淀粉酶检测。在订购了淀粉酶的患者中，通常将这些患者转诊至外科手术，这可能是因为淀粉酶正常化的记录时间可能比脂肪酶的记录速度要快。