Indications:
The measurement of plasma amylase evidence to suggest or confirm the diagnosis of pancreatitis in acute attack
These enzymes, which cleave the starch, are secreted by the pancreas and salivary glands. For they pass in serum, where it is normally absent, it is necessary that there be either ductal obstruction or tissue necrosis.
Serum amylase was removed within hours via urine.
Principle:
The total amylase activity can be measured in any biological fluid: serum, urine, ascites, pleural fluid …
Technique:
fasting patient.
Sampling 5 mL of blood in a dry tube or urine collection for 24 hours.However, micro-methods are becoming more widespread.
Amylases are assayed by colorimetric or enzymatic method; while it is possible to separate pancreatic and salivary amylase, one dose rather all lipase and amylase, as only pancreatic amylase is accompanied hyperlipasaemia.
Results:
Normal values:
If different results according to the standards of each laboratory, those clinical biological French society of 10 to 45 U / L.
Pathological changes:
– An elevation higher than 1000 U / L sign acute pancreatitis;
– But an increase is also seen;
* In the presence of any acute abdomen: perforated stomach ulcer, intestinal obstruction, mesenteric infarction, cholecystitis, hemoperitoneum,
* Breach of the salivary glands: tumors or infections, parotitis (mumps), salivary Lithines,
* In patients with renal insufficiency;
– The urinary amylase increases with a delay of 8:00 compared to amylase, but persisted much longer.
Cost:
B25.
Practical advice:
Alcoholism as a therapeutic injection or non-opiate causes of increased amylase. Parallel with the determination of amylase, the lipase may be advantageous.
The plasma activity of this enzyme increases with that pancreatic amylase if cancerous obstacle (the papilla of Vater for example), or gallstone pancreatitis.
