Decreased Amylase Levels in Chronic Pancreatitis Patients with Diabetes Mellitus

合併糖尿病之慢性胰臟炎患者胰澱粉酶較低

張勝雄(Shen-Shong Chang) ； 劉代鵬(Dai-Peng Liu) ； 黃信彰(Shinn-Jang Hwang)

《北市醫學雜誌》 2卷3期 (2005/03) Pp. 248-253

https://doi.org/10.6200/TCMJ.2005.2.3.03

摘要

背景：糖尿病可能出現無痛性心肌梗塞，回顧文獻慢性胰臟炎之腹痛是否也受糖尿病影響未曾被研究。慢性胰臟炎有無合併糖尿病之臨床差異是值得探討。方法：回溯性研究，自1992年至2003年，31位慢性胰臟炎患者因急性發作至台北市立陽明醫院急診求診記錄納入研究範圍。結果：慢性胰臟炎患者無論是否合併有糖尿病，並無人口幾何學與臨床症狀之差異，慢性胰臟炎主要發生於抽菸、喝酒之男性。無論是否合併有糖尿病，腹痛是主要的症狀(80% vs 9375%, p-0333)，而合併糖尿病之患者有較低的胰澱粉酶(95±127.58U/L vs 175.53±1126.98U/L, p=0001)。討論：慢性胰臟炎急性發作之腹痛並沒有受到糖尿病之影響，慢性胰臟炎有較低之血清胰澱粉酶，而合併糖尿病患者其血清胰澱粉酶會降的更低。

關鍵字

糖尿病 ； 慢性胰臟炎 ； 腹痛 ； 胰澱粉酶

並列摘要

Background: In diabetes mellitus (DM) patients, myocardial infarction can occur in the absence of chest pain. Whether DM similarly mutes abdominal pain in chronic pancreatitis is unknown. Methods: A retrospective cohort study of 31 patients (predominantly males who smoke and excessively drank alcohol) diagnosed as an exacerbation of chronic pancreatitis from January 1992 to December 2003 was undertaken in Taipei Municipal Yang-Ming hospital.
Results: No statistical differences were evident in patient demographics and initial symptoms/signs between DM and non-DM subjects. Abdominal pain was the major symptom in both DM and non-DM subjects (80% vs. 93.75%, p=0.333). DM subjects displayed serum amylase levels of 95±127.58U/L, while the levels in non-DM subjects was 175.53±1126.98U/L(p=0.001).
Discussion: Unlike asymptomatic coronary artery disease in DM patients, DM does not mute abdominal pain in chronic pancreatitis. However, serum amylase levels vary in acute versus chronic pancreatitis and, in the latter, between DM and non-DM subjects.

並列關鍵字

diabetes mellitus ； chronic pancreatitis ； abdominal pain ； serum amylase levels