[Diagnostic value of various laboratory parameters in acute pancreatitis]

In 427 samples of serum and urine, collected during their stay at hospital from 40 patients affected with acute pancreatitis, the sensitivity and the specifity of total amylase and lipase in serum, total amylase and pancreas isoamylase in urine, as well as the amylase-/creatinine clearance were determined. The pancreas isoamylase in serum was used as reference value. It appeared that the sensitivity of the lipase was next to that of the pancreas isoamylase in serum, even in limit ranges. Usually the lipase stayed pathological the longest and could therefore be used to identify in the best way even an easing-off pancreatitis. The diagnostic accuracy of the total amylase in serum and urine, of the pancreatic isoamylase in urine and of the amylase-/creatinine clearance was found to be obviously less reliable. The specifity of all examined tests was reduced in patients with renal insufficiency, liver disease, alcohol abuse and in patients with abdominal pains of non pancreatic origin. Concluding form our results and with regard to the expenditure of laboratory technique and to the time required by the methods of determination, we found that of all the examined parameters, the lipase was the most convenient for both emergency and routine diagnose of an acute pancreatitis.