ABSTRACT
Objective:
To investigate the
etiology,
prognosis and clinical characteristics of abnormal
serum amylase and
lipase in
children.
Methods:
This study was a
retrospective study.A total of 7 813
children older than 28 days
who had their
serum amylase and
lipase detected in Hunan
Children′s
Hospital from August 2017 to August 2020 were included as the study subjects.
Children with acute and
chronic pancreatitis were excluded.The age,
gender, impatient department, imaging exams, discharge outcomes, main
diagnosis, diagnostic ICD10 code, and the highest values of
serum amylase and
lipase during
hospitalization were collected through the
medical record system.According to the levels of
serum amylase and
lipase, the
children were divided into 3 groups.
Patients in group A had normal
serum amylase and
serum lipase levels.The
serum amylase or
lipase levels of
patients in group B was 1 to 3 times higher than that of group A. The
serum amylase or
lipase levels in group C was 3 times higher than that of group A. Group B and group C had abnormal pancreatic
enzyme levels.According to the
prognosis,
patients were divided into the
survival group and the
death group.The relationship of the occurrence of abnormal
serum amylase and
lipase levels with the age,
sex,
disease type and
prognosis of
children was analyzed.
Results:
The ratio of abnormal
trypsin in
male and
female was 11.5% and 12.9%, respectively.The number of
children with abnormal pancreatic
enzyme levels in the 28 day -1 year old group, >1-3 years old group, >3-6 years old group, >6 -12 years old group and > 12 year old group were 37 cases (4.6%), 185 cases (15.4%), 199 cases (10.5%), 431 cases (13.9%), and 94 cases (11.7%), respectively.The mortality rate was 1.6% (112/6 867 cases) in group A, 5.2% (32/617 cases) in group B, and 7.6% (25/329 cases) in group C. The
mortality risk of group B and C was both higher than that of group A. Compared with group A, the OR (95% CI) of group B and group C was 3.30 (2.21-4.93) and 4.96 (3.17-7.77), respectively.In group C, the top five
diseases were
parotitis (26.4%), cholangiectasis (11.6%),
choledochal cysts (8.5%),
gastroenteritis (4.5%) and
sepsis (3.3%).
Conclusions:
Pancreatic
enzyme abnormalities in
children are associated with adverse
prognosis.Pancreatic
enzyme abnormalities are more prone to occur in
children aged >1-3 with
mumps, digestive
diseases and
congenital digestive system structural
deformities.In addition,
children with
sepsis are also easy to present pancreatic
enzyme abnormalities.Clinical
attention should be paid to the possibility of
secondary pancreatic damage in
children with
sepsis.