THE SERIAL CHANGE OF AMYLASE AND AMYLASE ISOZYME IN THE BODY FLUID ON LAPAROTOMY

—The investigation of amylase isozyme and ACCR—

Abstract

Serial changes of amylase and amylase isoenzyme in body fluid before and after laparotomy were investigated in 50 patients. Serum amylase activity was diminished 1 to 3 hr after operation and was elevated at 12 hr. Total activity reached a maximum at 24 hr postoperative (24 hr preoperative baseline is 2.78±0.53 (X±SE) ) . Thereafter, serum amylase activity decreased gradually to baseline after 3 to 5 days postoperative. Meanwhile pancreatic P-amylase did not change significantly from preoperative levels. In contrast, fluctuation of S-amylase from the salivary glands and intestines was similar to that of the total activity, suggesting that transient hyperamylasemia after laparotomy is attributable to S-amylase activity. There was no direct relation between hyperamylasemia and operative time or target disease. This suggests that the elevation of serum amylase activity is mediated by a nonspecific mechanism. The 24 hr postoperative amylase-creatinine clearance ratio (ACCR) was 4.43±1.55 (%) . This was significantly (p<0.05) higher than the preoperative level of 3.73±1.0 (%) (X±SD) . In particular, the ACCR of S-amylase compared with that of P-amylase was not elevated. showing that this could be a factors in postoperative hyperamylasemia.