title: [Lipase/amylase ratio in biliary acute pancreatitis and alcoholic acute/acutized chronic pancreatitis].
abstract: BACKGROUND
  Alcoholic or biliary acute pancreatitis may need different therapeutic approaches.
  
  
  OBJECTIVE
  Assessing the validity of lipase/amylase ratio in differentiating biliary from alcoholic acute pancreatitis/acutized chronic pancreatitis.
  
  
  METHODS
  Nine male patients (mean age and standard deviation: 39.8 +/- 7.0 years) with alcoholic acute pancreatitis/acutized chronic pancreatitis (group I) and 29 patients, 8 male and 21 female (mean age: 43.6 +/-19.9 years), with biliary acute pancreatitis (group II) were evaluated. Serum lipase and amylase levels were measured in patients with symptoms for no more than 48 hours. The lipase/amylase ratio was calculated based on serum lipase and amylase levels and expressed as multiples of their respective superior reference values.
  
  
  RESULTS
  Mean levels of serum lipase (4,814 +/- 3,670 U/L) and amylase (1,282 +/- 777 U/L) in patients of group I were comparable to group II (2,697 +/- 2,391 and 1,878 +/- 1,319 U/L, respectively), but the mean lipase/amylase ratio was significantly higher in group I (4.4 +/- 3.6) than in group II (2.2 +/- 2.2). Lipase/amylase ratio >3 occurred at significantly higher proportions in patients of group I (66.7%) than of group II (24.1%), differentiating the two groups with sensitivity of 67% and specificity of 76%.
  
  
  CONCLUSIONS
  1) Amylase and lipase serum levels did not differ in the two groups evaluated; 2) the lipase/amylase ratio >3 was more often seen in alcoholic acute pancreatitis/acutized chronic pancreatitis than biliary acute pancreatitis, and it may be useful in differentiating these two causes of pancreatitis.
authors.affiliation: Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG.
authors.forename: Ricardo Custódio
authors.initials: RC
authors.lastname: Pacheco
authors.forename: Luiz Carlos Marques de
authors.initials: LC
authors.lastname: Oliveira
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000681:Amylases / Q000097:blood*; D001660:Biliary Tract Diseases / Q000150:complications*; D004796:Clinical Enzyme Tests; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008049:Lipase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000175:diagnosis* / Q000209:etiology; D019512:Pancreatitis, Alcoholic / Q000175:diagnosis / Q000201:enzymology; D050500:Pancreatitis, Chronic / Q000175:diagnosis / Q000201:enzymology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
chemical_list: D008049:Lipase; D000681:Amylases