一位急性胰臟炎病患主訴劇烈腹痛，護理師預期檢查結果中，哪項指標對此診斷最具特異性？
A client with acute pancreatitis presents with severe abdominal pain. Which laboratory finding would the nurse expect to find as the most specific indicator of this condition?
- AElevated alkaline phosphatase鹼性磷酸酶升高
- BElevated serum lipase✓ 正解血清脂解酶升高
- CElevated serum glucose血清葡萄糖升高
- DElevated white blood cell count白血球計數升高
在四個選項中，血清脂解酶（lipase）是急性胰臟炎最具特異性的實驗室指標，血中濃度上升明顯且維持較久（澱粉酶 amylase 也會升高但回到正常較快、特異性較低）。急性胰臟炎的診斷通常需符合三項中的兩項：典型上腹痛、酵素升高至正常上限 3 倍以上、影像學支持。其他選項：白血球升高僅顯示發炎反應；血糖偏高可能因胰島細胞受損但非診斷依據；鹼性磷酸酶通常與膽道或肝臟病變相關。
Serum lipase is the most specific laboratory indicator for acute pancreatitis, remaining elevated longer than amylase and providing greater diagnostic accuracy. While other findings like leukocytosis or hyperglycemia may occur, they are non-specific or secondary effects, whereas elevated lipase directly reflects pancreatic injury.
台美臨床皆將 Lipase 作為急性胰臟炎首選檢測；美國醫師常會要求每日追蹤趨勢，台灣則視病情輕重與醫師習慣而定。