Amylase determination.

: Child amylase determination: blood AMY normal, urine AMY 1881 (urine AMY<600), the next day to determine urinary amylase 172, the results are normal, clinicians think our results are not correct, but the two-day urine samples re-tested, the results are still so. Have you ever seen this happen to your seniors? Why?
: The amY elevation in the blood generally falls to normal after a peak of 2 to 5 days. AMY's decline in the urine is slower than amy in the blood, as the landlord said, the general appearance is unlikely, I think it is likely that the first day of the specimen was contaminated with saliva. Because saliva contains a large amount of AMY, patients and operators as long as a little attention, speech spit into the specimen, can cause the amY results in the specimen increased.
: I agree with the view of the 2nd floor. There are also the following questions to draw attention to: urine amylase influence a lot of factors, such as urine volume, drinking water, etc. If you can compare the ratio of secondary urine amylase/urinary creatinine, comparability is stronger.
: Agree with the two upstairs, and add a little personal superficial understanding:
1, amylase in the blood half-life is very short, about two hours (clinical
biochemistry
the third edition above the original words, as long as the kidneys are excluded, in the kidneys almost no reabsorbation, resulting in the amount of blood amylase and pancreatic necrotizing degree is not proportional (this is why the urinary amyloid reference range is greater than the blood). Also, if acute pancreatitis is to be diagnosed, blood AMY must be 3 times higher than normal (the standard of urine is not clear to me). When less than 3 times, you should do a CT check, in other words, a little higher is nothing. Moreover, amy can't rule out pancreatitis even if it's negative, which is the consensus.
2, for the above reasons, blood AMY is mainly used for the early diagnosis of acute pancreatitis. Urine is mainly used for late diagnosis, we imagine that the first test when the blood concentration is not high, urine is normal 3 times, indicating that the kidneys have been a lot of AMY in the blood, the average daily fluid flow inpatients said there are 500 ml, urine volume is certainly more than normal people, assuming that patients have high AMY concentration of urine out of the bladder, re-retention of course is very low urine concentration. Don't say every other day, even two hours can be a perfect possibility.
this and the doctor is not digestive, nor emergency, it is normal to have a misunderstanding of AMY, he may think that the rise and decrease of AMY and AST, ALT and so on. I estimate that the patient's clinical symptoms may be very serious, the doctor suspected acute pancreatitis, but there is no AMY this indicator, there is no way under the diagnosis of acute pancreatitis, not good to develop treatment measures, and the examination department is awkward. You must tell him that AMY negative can not rule out acute pancreatitis. I just read the U.S. guidelines for the treatment of acute pancreatitis in the last few months, which just emphasized that if a patient's diagnosis of acute pancreatitis has been established, it doesn't make much sense to monitor his AMY/LIP every day, in other words, if he has been diagnosed with acute pancreatitis, the patient's symptoms have not been alleviated, although subsequent examinations have found that AMY is reduced, but still in accordance with acute pancreatitis (quietly: those drugs used to treat acute pancreatitis are not harmful to the human body).
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