Buradasınız

Akut Pankreatitin Erken Tanısında İdrar Tripsinojen-2 Testinin Yeri

Urinary Trypsinogen-2 Analysis in Early Diagnosis of Acute Pancreatitis

Journal Name:

Publication Year:

Keywords (Original Language):

Abstract (2. Language): 
Purpose: The aim of this study is to evaluate the place and importance of the urinary trypsinogen-2 analysis in early diagnosis of acute pancreatitis. Materials and Method: The patients who admitted with abdominal pain to the surgery emergency service of Ministry of Health Ankara Dışkapı Yıldırım Beyazıt Training and Research Hospital were examined prospectively. Results: 76 female and 29 male total 105 patients were included in this study. The mean age was 53.3 (range 19-87). 51 of the patients were acute pancreatitis, 54 of them were the control group with other abdominal pathologies. Urinary trypsinogen-2 was analysed in all patients within 24 hours after admittance. The urinary trypsinogen-2 level was 96.1% positive in patients who was diagnosed as acute pancreatitis and 1.9 % was found positive in the control group (patients who had an extra-pancreatic illness). The sensitivity and specifity of the test was found to be 96% and 92% respectively . Conclusion: Urinary trypsinogen-2 test is a quick, efficient and reliable test in the early diagnosis of acute pancreatitis.
Abstract (Original Language): 
Amaç: Üriner tripsinojen-2 strip testinin akut pankreatit’in erken tanısındaki yeri ve öneminin araştırılması. Gereç ve Yöntem: Bu çalışma S. B. Ankara Dışkapı Yıldırım Beyazıt E. A. H. Acil Cerrahi Polikliniği’ne karın ağrısı ile başvuran olguların bilgilerinin prospektif olarak incelenmesi sonucunda gerçekleştirildi. Bulgular: Bu çalışmaya 76 kadın, 29 erkek toplam 105 olgu alındı. Yaş ortalaması 53.3 (en az 19-en çok 87) idi. Karın ağrısı ile başvuran 105 olgudan 51’i akut pankreatit, 54’ü de diğer karın hastalıkları olan kontrol grubu idi. Bu olguların hepsinin idrar örnekleri alındı ve başvuruyu takip eden ilk 24 saat içerisinde idrar tripsinojen-2 testi yapıldı. İdrarda tripsinojen-2 düzeyi, akut pankreatit tanısı alan olguların %96.1’inde, kontrol grubundaki olguların (pankreas dışı hastalığı olan olgular) ise %1.9’unda pozitif olarak bulunmuştur. Testin duyarlılığı %96 ve özgüllüğü %92 olarak bulundu. Sonuç: Akut pankreatitin erken tanısında idrar tripsinojen-2 testi hızlı sonuç alınan, etkin ve güvenilir bir yöntemdir.
13-16

REFERENCES

References: 

1. Yeo CJ, Cameron JL. Acute pancreatitis. Ed: Sabiston DC Jr., Lyerly HK.
Textbook of Surgery, 15th ed, W. B. Saunders Company 1997, 1156-65.
2. Corfield AP, Cooper MJ, Williamson RCN. Acute pancreatitis: a lethal disease of
increasing incidence. Gut 1985;26:724-9.
3. Hedstrom J, Sainio V, Kemppainen E, et al. Urinary trypsinogen 2 as a marker of
acute pancreatitis. Clin Chem. 1996;42(5):685-90.
4. Alexakis N, Neoptolemos JP. Algorithm for the diagnosis and treatment of acute
biliary pancreatitis. Scand J Surg 2005;94:124-9.
5. Mayer AD, McMahon MJ, Corfield AP, et al. Controlled clinical trial of peritoneal
lavage for the treatment of severe acute pancreatitis. N Engl J Med 1985;312:399-
404.
6. Holdsworth PJ, Mayer AD, Wilson DH, et al. A simple screening test for acute
pancreatitis. Br J Surg 1984;71:958-9.
7. Pekmezci S, Sarıbeyoğlu K. Akut pankreatit: Etyoloji, klinik, tanı, komplikasyonlar
ve medikal tedavi. Aktüel Gastroenteroloji ve Hepatoloji. Göksoy E, editör.
Bilimsel Medikal Yayıncılık, İstanbul, 2001. s. 188 – 205.
8. Steinberg W, Tenner S. Acute pancreatitis. N Engl J Med 1994;330:1198-1210.
9. Wong ECC, Butch AW, Rosenblum JL. The clinical chemistry laboratory and
acute pancreatitis. Clin Chem 1993;39:234-43.
10. Balthazar EJ. CT diagnosis and staging of acute pancreatitis. Radiol Clin North
Am 1989;27:19-37.
11. Itkonen O, Kiovunen E, Hurme M, et al. Time resolved immunoreactic assays for
evaluation of trpysinogen 2 in pancreatitis. J Lab Clin Med 1990;115:712-8.
12. Durie P, Gaskin K, Geokas M, et al. Plasma immuoreactic trypsin in cystic
fibrosis. J Pediatr Gastroenterol Nutr 1982;1:337-43.
13. Kimland M, Russick C, Marks WH, et al. Immunoreactive anionic and cationic
trypsin in human serum. Clin Chem Acta 1989;184:31-46.
14. Kemppainen EA, Hedstrom J, Puolakkainen PA, et al. Rapid measurement of
urinary trypsinogen 2 as a screening test for acute pancreatitis. N Engl J Med
1997;336:1788-93.
15. Kylanpaa-Back M, Kemppainen E, Puolakkainen P, et al. Reliable screening for
acute pancreatitis wiyh rapid urine trypsinogen 2 strip test. Br J Surg
2000;87(1):49-52.
16. Hedstrom J, Sainio V, Kemppainen E, et al. Urine trypsinogen 2 as a marker of
acute pancreatitis. Clin Chem 1996;42(5):685-90.
17. Hedstrom J, Korvuo A, Kenkimaki P, et al. Urinary trypsinogen 2 strip test for
acute pancreatitis. Lancet 1996 Mar 16;347(9003):729-30.
18. Kemppainen E, Hedstrom J, Puolakkainen P, et al. Urinary trypsinogen 2 stip test
in detecting ERCP induced pancreatitis. Endoscopy. 1997 May,29(4):247-51.
19. Hedstrom J, Haglund C, Haapiainen R, et al. Serum trypsinogen 2 and trypsin 2
alfa 1 antitrypsin complex in malignant and benign digestive tract disease:
preferential elevation in patients with colangiocarcinomas. Int J Cancer
1996;66:326-31.
20. Terada T, Nakanuma V. Immunohistochemical demonstration of pancreatic alpha
amylase and trypsin in intrahepatic bile ducts and peribiliary glands. Hepatology
1994;14:1129-35.
21. Chen YT, Chen CC, Wang SS, et al. Rapid urinary trypsinogen-2 test strip in the
diagnosis of acute pancreatitis. Pancreas. 2005;30(3):243-7.
22. Hedstrom J, Kemppainen E, Andersen J, et al. A comparison of serum
trypsinogen-2 and trypsin-2-alpha1-antitrypsin complex with lipase and amylase in
the diagnosis and assessment of severity in the early phase of acute pancreatitis.
Am J Gastroenterol. 2001 Feb;96(2):424-30.
23. Saez J, Martinez J, Trigo C, et al. Clinical value of rapid urine trypsinogen-2 test
strip, urinary trypsinogen activation peptide, and serum and urinary activation
peptide of carboxypeptidase B in acute pancreatitis. World J
Gastroenterol.2005Dec14;11(46):7261-5.

Thank you for copying data from http://www.arastirmax.com