— 生理適應 · MEDIUM · MCQ —
一位急性胰臟炎病人表現出嚴重上腹痛與嘔吐。下列哪項實驗室檢查結果最能特異性診斷此疾病？
A client with acute pancreatitis presents with severe epigastric pain and vomiting. Which laboratory finding is the most specific indicator for this condition?
- AElevated white blood cell count白血球計數升高
- BElevated serum lipase✓ 正解血清脂解酶（lipase）升高
- CElevated blood glucose血糖升高
- DElevated serum amylase血清澱粉酶（amylase）升高
— Explanation · 中文詳解 —
脂解酶（Lipase）是診斷急性胰臟炎最具有特異性的檢查。澱粉酶（Amylase）雖亦會升高，但會受到其他腸胃道疾病干擾，且其恢復正常的速度較快，敏感度與特異性均不如脂解酶。高血糖與白血球增加為相關併發症或發炎指標，非診斷首選。
Lipase is the most specific laboratory test for diagnosing acute pancreatitis. Although amylase is also elevated, it is influenced by other gastrointestinal disorders and returns to normal more rapidly, so its sensitivity and specificity are both inferior to those of lipase. Hyperglycemia and leukocytosis are related complications or inflammatory indicators, not the primary diagnostic markers.
✦ 台美臨床差異
美台臨床對於急性胰臟炎的診斷均高度仰賴血清脂解酶值。台灣醫師對於病史詢問較為細緻，美國則強調護理師應評估疼痛惡化狀況。