What blood counts indicate pancreatitis? Pancreatitis

The pancreas performs one of the important functions in the system gastrointestinal tract, produces pancreatic juice. This substance contains digestive enzymes that provide the breakdown of proteins, fats and carbohydrates for their further absorption by the body. Pancreatitis is inflammation pancreas... Over the past 40 years, cases of this disease have doubled. How to define pancreatitis in the laboratory?

Diagnostics

The patient is brought to the doctor with suspected specific symptoms of pancreatitis. If the disease is acute, the signs of pancreatitis are bright, pain syndrome strong. In a chronic illness, symptoms are not so pronounced, but malaise is constantly present.

The following symptoms indicate pancreatitis:

• Feeling of general weakness, powerlessness.
• Nausea and vomiting that comes on spontaneously but does not provide relief.
• Painful sensations in the abdomen, which radiate to the back.
• Heart palpitations.
• Stool change, residues of undigested food are present in the excrement.

After a visit to the doctor, anamnesis is collected, the patient's complaints about the state of health. Based on the results of the examination, appropriate laboratory research... If pancreatitis is suspected, general and biochemical analysiss blood. Urinalysis, stool analysis, X-ray, saliva analysis, and others may also be prescribed.

General analysis

In a general blood test, there are a number of indicators that can indicate the development of the disease in the patient's body. Despite the generalized data, the level of leukocytes, erythrocytes and ESR is noted in the blood test. A biological sample, as a rule, is submitted immediately for general and biochemical analyzes.

This means that you should come to the laboratory on an empty stomach.

What indicators are used to diagnose pancreatitis in a general blood test:

• An increased ESR and C-reactive protein level indicates the presence of inflammatory process in organism. IN eSR rate is 0-15 for men and 0-20 for women.
• An increase in the total white blood cell count corresponds to a state in which the body is actively producing white blood cells to fight inflammation. Normally, in adult men and women, the number of leukocytes should be in the range of 4-9 × 10 9 liters.
• If pancreatitis gave a hemorrhagic complication, in the general analysis, the level of hemoglobin and red blood cells will be reduced. Normally, erythrocytes are in the range of 3.9-5.5 × 10 12 in men, and 3.9-4.7 × 10 12 cells / l.
• Sometimes there is a decrease in the rate of eosinophils. This type of leukocytes makes up 1-5 percent of the total leukocyte mass or 0-0.45 × 10 9 L.

Clinical blood test for pancreatitis and indicators are generalized and do not allow a diagnosis. The general study is auxiliary, confirming the results of biochemistry. At the same time, the studied parameters make it possible to find out the general state of health of the patient and evaluate the effect of the disease on the body.

Biochemistry

Biochemical research is a complex process that can contain great amount indicators of the studied parameters. Only a few are used to diagnose pancreatitis. A blood test for an acute illness is carried out within 24 hours from the moment the patient contacts a medical facility.

It is necessary to determine the following indicators:

• Sugar levels in patients with pancreatitis will be increased. This will indicate changes in the structure of the pancreas due to pancreatitis. Normally, the glucose indicator is in the range of 3.9-5.8 mmol / l.
• As a result of the tests, there will be a significant increase in the level of enzymes that are associated with the functioning of the liver (elastase, phospholipase, trypsin, lipase). An increase in bilirubin indicates the formation of gallstones.
• The main parameter for the diagnosis of pancreatitis in a blood test is alpha-amylase. If the indicator is 4-5 times higher than the norm, the patient is diagnosed with pancreatitis. The norm for an adult is 0-50 U / l.
• Low alpha-amylase activity indicates possible necrosis and complete breakdown of the pancreas.
• An increase in elastase-1 in the patient's biological sample indicates an acute course of the disease, as well as the development of foci of necrosis. This indicator is researched only in modern laboratories equipped with the latest technology.
• The total protein index is significantly reduced relative to the indicated norm. For an adult, the norm is 65-85 g / l.

Analysis of urine

Urine tests are quite informative for a doctor. The biological sample is collected by patients at home on their own and delivered to the laboratory for analysis. The doctor will preliminarily give instructions that should be followed to obtain the most reliable information based on the research results. The following parameters of the biological sample are taken into account:

• Urine healthy person should be transparent. The presence of turbidity indicates the presence of pus, as a result of the presence of purulent inflammation inside the body.
• Normally, the color of the liquid should be light yellow. With pancreatitis and kidney disease, the color may change to a darker one.
• Macho is also tested for glucose levels. Normally, sugar should not be present in the urine, but if the analysis is positive, this indicates the development of acute pancreatitis, diabetes mellitus or impaired renal function.
• The appearance of hemoglobin in the urine, even in small amounts, indicates pancreatitis, poisoning, hypothermia, or some chronic diseases.

Stool analysis

A change in the structure of Cola is one of the symptoms of pancreatitis. It is this type of research in its current form that reflects the functional level of the pancreas. If the secretion of digestive enzymes produced by the gland is reduced, then pancreatitis can be diagnosed.

Depending on the degree of development of the disease, the dysfunction of the pancreas will be expressed more and more.

With pancreatitis, the following manifestations are observed:

• Persistent bad smell excrement
• Feces are poorly washed off the walls of the toilet
• Undigested food particles are present in feces
• Feces have a shiny surface
• Laboratory analysis detects the presence of fat in the stool
• When the biliary tract is blocked, the stool will have a light shade
• Frequent urge to empty
• Loose stools

As additional research methods can be used different types tests for pancreatitis. For example, saliva analysis helps to identify the concentration of pancreatic enzymes. By the result of this analysis, you can find out the severity and degree of development of pancreatitis. Also, this type of research greatly simplifies laboratory diagnostics and allows you to monitor the dynamics of pancreatitis.

Pancreatitis is a serious pathological condition that can lead to serious consequences for the body. Upon detection specific symptoms pancreatitis, you must immediately consult a doctor for help. Conducting laboratory tests will not take much time, but it will help to establish a diagnosis in a timely manner and choose the most effective treatment.

In contact with

Clinical signs of inflammation of the pancreas are difficult to distinguish from other diseases of the digestive tract, they all cause similar symptoms: abdominal pain, dyspepsia. In this case main role play blood tests for pancreatitis. Other tests, for example, examination of feces, saliva, urine, establish the form of pancreatitis - acute or chronic. For a doctor treating pancreatitis, you need to know for sure whether he is dealing with an acute form of the disease or an exacerbation of a chronic inflammatory process in the gland.

The pancreas, breaking down proteins, fats and carbohydrates, and also synthesizes the hormone insulin, which delivers glucose to the cells of the body. Diagnosis of pancreatitis involves determining the concentration of digestive enzymes and hormones of the gland in the bloodstream.

• Amylase - participates in the processing of carbohydrate foods (breaks down starch); distinguish between pancreatic amylase and total α-amylase (diastase).
• Trypsin and elastase - provide assimilation of proteins.
• Lipase - breaks down fats, its deficiency is detected by an increase in cholesterol in the analyzes.

Lack of insulin leads to high blood sugar levels.

Pancreatic enzymes normally only become active in the intestines. If the movement of pancreatic juice along the ducts to the intestine is difficult, some of the enzymes are activated in the organ itself "digesting" it - an inflammatory process occurs. It can be sluggish, proceed without pain, but is accompanied by the degeneration of organ tissues, which are deprived of secretory activity. Analyzes for chronic pancreatitis reveal pathological processes and functional pancreatic insufficiency. If chronic pancreatitis is suspected, diagnosis includes such laboratory tests;

1. Complete blood count (CBC) - detects inflammation in the body;
2. Biochemical analysis - the most important diagnostic study in pancreatitis - provides information on the content of digestive enzymes, as well as glucose, cholesterol in the blood.
3. Analysis of urine for diastase - may show a slight, but long-term excess of amylase in the urine - a sign of chronic pancreatitis; a decrease in amylase in comparison with the norm indicates a degeneration of the gland tissues.
4. : greasy, greasy stools with undigested food debris indicate dysfunction of the pancreas.
5. Analysis of saliva for amylase levels will help differentiate acute from chronic inflammation.

Is in the organization proper nutrition and taking medications that correct the secretory insufficiency of the organ. Sick people quickly understand. It is worth breaking the diet with pancreatitis, as a painful attack begins after a few hours, which must be distinguished from the acute form of inflammation of the pancreas.

Diagnostics of the acute pancreatitis

When acute inflammation there is an intensive destruction of the gland tissue by its own enzymes, which is accompanied by poisoning and a deterioration in the general condition of the body. Diagnosis of pancreatitis in its acute form begins with taking into account the clinical manifestations. The main symptom is pancreatic colic - sharp pain in the epigastric region, it is so strong that the patient loses consciousness.

The pain syndrome is aggravated by bouts of vomiting that do not bring relief. In such a situation, doctors prescribe tests that are necessary to establish the fact of inflammation in the body, to assess the degree of damage to the gland. Standard tests for pancreatitis are marked "cito!" And should be done as soon as possible:

• complete blood count (CBC);
• blood biochemistry - different sharp rise the content of amylase in the blood, since with such a pathology it is activated not in the intestine, but in the pancreas itself and enters the bloodstream;
• urine shows an increase in diastase sometimes 200-250 times; to control the dynamics of acute inflammation, urine should be taken every three hours;
• stool analysis for acute pancreatitis may indicate that the process of food digestion is disrupted.

An increase in amylase in the blood is also characteristic of pathologies such as cholecystitis, diabetes mellitus, and pain syndrome of the "acute abdomen" type may indicate appendicitis, perforation of an ulcer and other diseases abdominal cavity... To clarify pancreatitis, you need differential diagnosis... Before recognizing acute inflammation, the pancreas is examined by others, MRI, radiography, - determine the localization of the pathology, its nature (inflammation, cyst, tumor).

Blood tests

Informative tests for pancreatitis are a blood test: blood is taken from a finger for general analysis; from a vein - for biochemical.

General analysis

General analysis data show the presence of an inflammatory process in the body. In acute pancreatitis, the blood count changes significantly.

• The number of leukocytes sometimes increases tenfold. Normally, the content of leukocytes is no more than 9 ∙ 109 / l.
• The erythrocyte sedimentation rate (ESR) increases, its normal indicator is 15-20 mm / h.
• The hematocrit (the ratio of the volume of erythrocytes and plasma) increases, the blood becomes thick due to a violation of the water-salt balance, fluid loss. The normal hematocrit is 46-48%.

When chronic inflammation pancreas, the following changes are noted in the blood test:

• the number of leukocytes sometimes even decreases, but usually a slight increase is observed for a long time;
• ESR slows down;
• there is a decrease in hemoglobin levels - which indicates the developing anemia against the background of depletion of the body. Normal hemoglobin level - 120-160 g / l

Blood biochemistry

In the course of a biochemical blood test for pancreatitis, attention is paid to the following data:

• the level of enzymes that the pancreas produces: diastase, lipase, trypsin;
• glucose content;
• the amount of proteins of the acute phase of inflammation (globulins, C-reactive protein);
• total protein concentration.

A complication in the development of pancreatitis is indicated in a blood test by a low calcium content, the appearance of tumor markers, and an increase in glycosylated hemoglobin.

Pancreatic enzymes

With inflammation of the pancreas, its cells are destroyed, the enzymes that were in them enter the blood - the level of their content increases sharply, which indicates the activity of the inflammatory process.

Amylase

Most characteristic feature pancreatitis - a jump in amylase in the blood. At the very beginning of acute pancreatitis and in the first hours of recurrence of a chronic disease, fast growth pancreatic amylase in the bloodstream. This indicator reaches its maximum value by the end of the first day, then it decreases, and on day 4-5 it gradually normalizes.

It should be noted that the value of total amylase (diastase) does not always indicate the development of pancreatitis. This enzyme is produced by both the pancreas (P-type) and the salivary glands (S-type). Growth of α-amylase at normal performance P-type is not a sign of pancreatitis. When chronic form diseases sometimes there is even a decrease in the enzyme in the blood, which may indicate a deep damage to the gland cells that produce this secret.

Lipase

As part of pancreatic juice, lipase enters the intestines, where it promotes the breakdown of dietary fats. Its content in blood should be 20 thousand times less than in pancreatic juice. An increase in lipase levels in the bloodstream - hyperlipasemia - means that fatty foods in the intestines are not completely digested, this leads to increased content cholesterol in the blood, as well as changes in feces. Both of these signs, against the background of an increase in lipase in the blood, make it possible to diagnose pancreatitis and other pathologies of the pancreas. The lipase level in acute pancreatitis begins to grow on the second day after the onset of inflammation and remains at a height of 1.5-2 weeks, exceeding the norm by 5-10 times.

Currently, a radioimmunological method has been developed for the determination of trypsin and phospholipase in blood serum. With exacerbation of pancreatitis, phospholipase activation increases tens and even hundreds of times (at a rate of 2-7.9 ng / l, it reaches 400 ng / l). A low lipase level indicates damage to the gland cells that synthesize enzymes.

Proteases: trypsin and elastase

Proteases break down protein foods in the intestines; if the pancreatic ducts are disturbed, they enter the bloodstream instead of the digestive tract.

• The content of trypsin in the blood at acute forms pancreatitis increases in comparison with the norm by 12-70 times - on the first day of illness, and then quickly decreases to the usual level. Chronic course the disease is accompanied by a low level of trypsin (2-10 times lower than normal), which is an indicator of the death of gland cells that secrete enzymes.
• Elastase is an enzyme that, in acute pancreatitis, remains at a high level for 7-10 days of illness. At this time, in many patients, the content of lipase and amylase is already returning to normal, but the amount of elastase remains significant in 100% of patients with pancreatitis. The higher the concentration of elastase in the blood, the more affected by inflammation of iron, the wider the area of \u200b\u200bnecrosis and the worse the prognosis of the disease. In chronic pancreatitis, the diagnosis is carried out by the content of elastase in the feces, its low content indicates a weakening of the ability of the gland to synthesize digestive enzymes.

Glucose level

If inflammation captures the endocrine cells of the gland, synthesizing insulin, against the background of its deficiency, an increase in blood sugar occurs. Without insulin, the absorption of glucose by the cells of the body is impossible. The glucose level is very important, since diabetes mellitus is one of the most common complications of pancreatitis. More accurate is the glycated (glucose-bound) hemoglobin, which gives an idea of \u200b\u200bthe blood sugar level over three months.

With pancreatitis, the protein content in the blood changes.

• The amount of acute phase proteins (C-reactive protein, fibrinogen) is growing - they appear in the blood during any inflammatory processes. With successful relief of inflammation, their number decreases.
• The concentration of total protein and albumin decreases - this is due to digestive upset: food entering the intestine is not completely digested due to, is not absorbed into the blood, but leaves the body with fecal residues. This indicator is especially characteristic in chronic pancreatitis.

Other indicators

In some cases, other indicators are involved in the diagnosis of pancreatitis.

• With inflammation of the pancreas, the concentration of the enzymes ALT (alanine aminotransferase) and AST (aspartate aminotransferase) increases. Normally, these compounds are inside cells, participating in protein metabolism. With pathological destruction of cells, enzymes enter the bloodstream. An increase in ALT and AST in the blood is not only a sign of pancreatitis, it also accompanies diseases of the liver, heart, and severe muscle injuries. In combination with other symptoms of pancreatic pathology, ALT and AST indicators are used to clarify the diagnosis. In acute pancreatitis, the concentration of AST exceeds the norm by 2-5 times, and the ALT enzyme - 6-10 times.
• Determination of tumor markers in the blood is prescribed to exclude a severe complication of pancreatitis - pancreatic cancer. Proteins CA 19-9 and CEA (cancer embryonic antigen), which are produced by degenerated cells, are specific for the pathology of the gland. An increase in C 19-9 three times and CEA twice is a sign of pancreatitis, if these indicators are exceeded, they talk about the possible development malignant tumor in the gland. In some cases, a positive result for tumor markers indicates diseases of the liver, stomach, and not the pancreas.
• An increase in bilirubin is observed in the case of an increase in the size of the inflamed pancreas, which makes it difficult for the outflow of enzymes from the gallbladder.

Analysis of urine

Informative in the diagnosis of pancreatitis is a biochemical analysis of urine. The color of urine becomes a sign of the disease: the light yellow color changes with inflammation to dark yellow to brown. In the analysis of urine, an increase in diastase is observed. The more active the inflammatory process, the sharper it rises. This indicator is typical not only for acute pancreatitis, amylase in urine also increases with diabetes mellitus... The companions of severe inflammation are ketone bodies, leukocytes and erythrocytes present in the urine. Protein in urine is found when its absorption in the intestine is impaired. urine has to be passed repeatedly to control the dynamics of amylase in the body.

Urine analysis in chronic disease of the gland shows a decrease in the level of α-amylase, which is associated with a weakening of the secretory functions of the gland in long-term pathology.

Stool analysis

If you have symptoms of inflammation of the pancreas, you need to donate feces for examination to clarify the diagnosis. To get reliable results, take tests after a dietary meal. You need to consume 105 g of protein food, 180 g of carbohydrate, 135 g of fat. The analysis of feces in pancreatitis provides information about functional disorders of the pancreas.

• The increased fat content makes the feces shiny, with a greasy consistency and a high content of fatty acids - evidence of a lack of the lipase enzyme in the intestine.
• Changes in feces also concern its color: with pancreatitis, it acquires a grayish tint.
• The presence of undigested residues indicates a general lack of enzymes in the intestine.
• The decrease in the level of elastase-1 in the feces shows how much the secretory function of the pancreas is reduced. In severe cases, fecal elastase levels fall below 100 mcg / g.

Deciphering biochemical analysis

The final formulation of the diagnosis is made on the basis of research: laboratory and instrumental. When diagnosing inflammation of the pancreas, the main thing is a blood test for pancreatitis, it gives indicators of deviations from the norm of gland enzymes:

• the level of pancreatic amylase in the blood should not exceed 54 units, with pancreatitis it sharply increases on the first day of the disease;
• the normal lipase content is up to 1.60 units / l, in acute pancreatitis it increases 5-20 times;
• the normal trypsin content is 10-60 μg / l, an increase indicates an acute inflammation, a decrease in the indicator indicates a chronic process.
• The upper limit of the norm of elastase in the bloodstream is 4 ng / ml, the greater the excess, the more severe the form of the disease.

Laboratory examination provides other informative indicators.

• The sugar content in the bloodstream should not be higher than 5.5 mmol / l, with pancreatitis it rises.
• The total protein content in healthy people is 64 g / l, a decrease in it indicates a pathology of the pancreas, nutritional deficiencies or intestinal diseases.
• Protein norm CA 19-9 - up to 34 units / l; exceeding the level is a sign of pancreatitis, a significant increase is a suspicion of oncology.
• The norm of cholesterol in the blood is 6.7 mmol / l, in men its level is higher than in women. With diabetes mellitus, pancreatitis, the cholesterol content rises.
• The enzymes AST and ALT are normally up to 41 mmol / l, if the indicator is increased, there is reason to diagnose pancreatitis.

With diversity diagnostic methods and indicators informative for the attending physician are the value on the first day of the disease and the determination of lipase and elastase in the following days.

Pancreatitis is an inflammation of the pancreas. An untreated disease leads to severe changes in the organ, which is marked by serious metabolic disorders. The role of the pancreas in the body is the synthesis of hormones, the production of pancreatic juice. The causes of the disease are poor nutrition, poor ecology, and chronic alcoholism.

With the question of what tests are carried out, you need to consult a doctor in order to establish the correct diagnosis.

Pathology is detected using different methods diagnostics:

• laboratory research;
• x-ray;
• ultrasound examination of the bile ducts or liver;
• x-ray examination of the duodenum;
• fibrogastroduodenoscopy (FGDS);
• biochemistry.

In chronic pancreatitis, tests are carried out in a laboratory. In patients with a diagnosis of pancreatitis, they are aimed at determining the composition of pancreatic juice, determining the effect of glucose on the body. Sometimes a scatological examination (stool analysis) is prescribed.

How is acute pancreatitis diagnosed?

With acute pancreatitis medical workers examine the liquid by piercing abdominal wall... Prescribed laparoscopy - an operation performed with a laparoscope through small holes internal organs... An endoscopy is also performed, an x-ray is done. Ulcers are found using X-ray or tomography. The examinations are carried out in different ways, taking into account the patient's well-being.

Diagnosis of pancreatitis consists in taking blood, feces and urine tests. Patients are prescribed x-rays and fluoroscopy.

What tests are done for acute pancreatitis?

To find out the causes of the onset of the disease, a comprehensive examination of the internal organs is carried out. Patients are tested for feces, saliva, urine, as well as a blood test for pancreatitis.

Blood test

A blood test for pancreatitis is taken early in the morning before breakfast. The diagnosis is confirmed if the amount of the AST enzyme is higher than normal. In patients, the indicator is above 55 units. Symptoms are manifested by a sharp weight loss, abdominal pain, diarrhea.

Blood for lipase is taken from a vein in the morning before meals. Lipase is an important enzyme involved in the breakdown of fats. Before the examination, the patient is prohibited from fatty, spicy and spicy dishes. In some cases, the diagnosis is carried out at any time of the day.

Lipase is investigated in two ways - enzymatic and immunochemical. In practice, the first method is more often used, which shows quick results. An auxiliary method of research is a biochemical blood test, which clarifies the diagnosis.

Analysis of urine

For abdominal pains, a urine sample is taken for the presence of an enzyme that breaks down carbohydrates - diastase. Pancreatic diastasis is produced by the pancreas, then the enzyme enters the urine.

Testing begins in the morning. Secondary urine is given throughout the day. The diastase rate in sick people exceeds 64 units. Similar indicators appear for problems associated with the pancreas, cholecystitis, peritonitis.

Blood and urine tests are important to do on early stages disease. It is easiest when the amount of diastase increases markedly. With a protracted form of the disease, an increased level of the enzyme lasts for several weeks. If the decrease in indicators is too sharp, this indicates a complication of the disease, and not a complete cure.

Stool analysis

Stool is examined for undigested fiber, stool consistency, fat and fatty acids.

Research is carried out at acute current diseases. Similar diagnostics provides information on the state of external secretion, enzyme activity. For this purpose, tests are carried out used to establish the diagnosis of diabetes mellitus.

How is acute pancreatitis diagnosed in children?

1. The urine should appear light yellow in color. A high concentration indicates digestive problems, kidney disease.
2. The liquid must remain clear. Clouding indicates the presence of pus.
3. Tumors in the pancreas may be indicated by yellow pigments (bilirubin).
4. In a normal urinalysis, glucose should not be present. It is determined in diabetes mellitus, impaired renal function and acute pancreatitis.
5. Hemoglobin in the urine of a healthy person should not appear. Its presence indicates poisoning, hypothermia and lingering illnesses.

How to properly prepare for a medical examination?

Tests should be taken in the morning before meals. To obtain objective results, you do not need to consume alcohol and drugs on the eve of the procedure. Large physical exercise definitely affect the result. When assessing the indicators, the doctor is guided by many factors - age, gender, physiological state of the patient.

But there are factors that do not depend on the above characteristics. Let's consider the main ones.

Food

It is not recommended to eat food for twelve hours before taking tests. This is an important condition that affects the assessment of indicators.

When donating blood after a meal, a lot of fat is concentrated in the liquid. In this case, the results will be highly controversial. This will lead to an incorrect diagnosis.

Beverages

Drinking strong coffee or tea will affect the determination of glucose tolerance. Alcohol can reduce levels.

Physical exercise

Medicines

Certain types of drugs have a profound effect on the results of medical research. Paracetamol and ascorbic acid increase glucose levels.

If possible, drugs should not be taken before the tests, this will affect the doctor's conclusion and the establishment of the correct diagnosis.

Sleep

On the eve of the tests, it is better to go to bed early and get up at least an hour before donating blood.

When is the best time to donate blood?

It is better to donate blood before ultrasound examination, massage, X-ray, physiotherapy.

Laboratory tests for pancreatitis should be taken in the laboratory, at the same time, to obtain objective results and correct diagnosis.

And also with pancreatitis, it is rather inaccurate, since it is similar various diseases digestive tract. To determine an accurate diagnosis, separate it from other pathologies and begin treatment as soon as possible, it is necessary to undergo a series of examinations. Analyzes for pancreatitis (blood, urine and feces) will determine the exact problem, the presence of an ailment and an area of \u200b\u200binflammation in the gastrointestinal tract.

Symptoms inherent in this ailment

It is important to know that even initial form pancreatitis can develop into, from which about 70% of patients die.

Complete blood count for pancreatitis

Tests for acute pancreatitis or chronic form pathologies are not particularly different. So, you can not do without blood sampling, which allows you to determine the presence of inflammation in the body.

The characteristics of blood in the presence of this ailment in a person will be as follows:

• a decrease in hemoglobin and erythrocytes, which occurs due to complications from pancreatitis;
• high leukocyte counts, sometimes even ten times, is a sign of inflammation in the body;
• rapid erythrocyte sedimentation;
• high hematocrit is a sign of violations in the water and electrolyte balance.

Biochemical blood test for pancreatitis

The main tests for chronic or acute pancreatitis are blood biochemistry, which allows you to study the work of all body systems.

If a person suffers from pancreatitis, the results of a biomaterial study will be as follows:

• high amylase, which is an enzyme of the gland and is responsible for dissolving starch;
• high elastase, lipase and trypsin;
• increased glucose levels due to lack of production;
• the amount of bilirubin that will be higher than normal;
• low protein levels;
• high rate of transaminases.

The main thing to pay attention to when studying the test results for pancreatitis is an increase in pancreatic enzymes.

General and biochemical analyzes are carried out after hospitalization, then the study will need to be performed only occasionally, to control the condition. For example, constant pain and high levels of enzymes indicate that the disease is progressing, developing into an acute form.

If the patient is admitted to the hospital only a few days after the first signs appear, the level of lipase, which remains in the blood for several days, will most accurately tell about the problems.

How to determine pancreatitis by tests as accurately as possible? To diagnose destruction of the gland, it is better to study the level of serum elastase.

The total volume in the blood can tell about the presence of acute pancreatitis. The higher the indicator, the more areas of inflammation in the organ, which worsens the patient's position.

The most accurate analysis of plasma neutrophil elastase is considered, but not every clinic can offer such a study.

It is important that elastase, in the presence of pancreatitis and inflammation, remains elevated for about 10 days. Therefore, the study can be carried out by patients who immediately went to the hospital or waited several days and only then came to the doctor.

As for the preparation for the analysis, nothing special is required from the patient.

Blood should be donated on an empty stomach early in the morning. This requires venous blood, but fingerstick blood is sufficient for a general analysis.

The doctor will tell you in more detail about all the nuances of preparation.

Study of the patient's feces

The collection and examination of feces helps to determine the state of the pancreas at the moment and how it functions.

Since the deterioration in the production of digestive enzymes affects the process of digestion of fats, this is clearly visible in the appearance and structure of feces.

The fact that the patient has problems with the pancreas may indicate:

• fats in feces;
• the presence of food leftovers;
• light shade of feces.

Negative changes in the work of the pancreas can be determined by the state of feces, even without studying its composition. Since the material will be shiny, it is not easily washed off with water from the surface, has a liquid consistency and has a very unpleasant odor. This is due to the process of decay of undigested proteins.

Often, a stool test alone will not be enough, additional tests will be required, for example, insertion of a tube or sampling of pancreatic juice.

Additional tests for pancreatitis

The symptoms of both acute and chronic pancreatitis are nonspecific. They prevent doctors from establishing correct diagnosis, since they are found in dozens of other diseases. Therefore, analyzes are of great importance in the diagnosis of pancreatitis. Changes in the blood, feces and urine allow the doctor with a high degree of probability to establish the presence of an inflammatory process in the pancreas.

Clinical blood test

A clinical blood test for pancreatitis is only of auxiliary value. It gives the doctor the opportunity to suspect the presence of an inflammatory process in the body. With the help of a CBC, it can also detect dehydration.

With pancreatitis, the following changes in the clinical blood test are observed:

• a decrease in the level of hemoglobin and the number of red blood cells is a consequence of blood loss, a possible sign of hemorrhagic complications of pancreatitis;
• an increase in the number of leukocytes, sometimes tens of times - a consequence of the inflammatory process;
• the erythrocyte sedimentation rate is increased - another sign of a systemic inflammatory response of the body;
• an increase in hematocrit (the ratio of blood cells to its liquid part) - indicates a violation of the water-electrolyte balance.

Blood chemistry

The most important in the diagnosis of pancreatitis is a biochemical blood test. It is he who allows you to determine the functional state of the whole organism.

With pancreatitis, the following changes in the chemical composition of the blood are observed:

• an increase in the level of amylase - a pancreatic enzyme that breaks down starch;
• increased levels of elastase, lipase, trypsin, phospholipase;
• an increase in blood glucose levels, which is associated with insufficient insulin secretion;
• an increase in the amount of bilirubin is a laboratory sign observed in the case of the overlap of the enlarged pancreas of the biliary tract;
• a decrease in the level of total protein is a consequence of protein-energy starvation;
• sometimes - an increase in the level of transaminases.

An increase in the level of pancreatic enzymes, primarily amylase, is the most important criterion in the diagnosis of pancreatitis.

A biochemical blood test is done on the first day after hospitalization. In the future, the level of amylase in the blood can be determined in order to monitor the state of the pancreas in dynamics. For example, an increase in the amount of pancreatic enzymes in the blood against a background of increased abdominal pain may indicate the progression of the disease or warn the doctor about possible complications pancreatitis.

Determination of lipase in blood has much less specificity. The amount of this enzyme increases not only with pancreatitis. For example, an increase in lipase concentration is observed in more than half of patients with liver and biliary tract pathology. But lipase stays in the blood longer than amylase, so its determination is useful in diagnosis if a person is admitted to the hospital only a few days after the onset of symptoms of pancreatitis.

When determining the destruction of the pancreas, the most important diagnostic value is serum elastase level... The amount of this enzyme in the blood is most often observed in acute pancreatitis. The higher the level of this enzyme, the more extensive the foci of necrosis in the pancreas, and the worse the prognosis for the patient. The greatest accuracy in determining the scale of organ destruction is provided by the determination of neutrophil elastase in blood plasma, but this method is not practiced in most laboratories and is available only to doctors of leading clinics in the country.

Unlike all other pancreatic enzymes, the level of elastase remains elevated in all patients without exception within 10 days from the onset of the disease. For comparison, in the same period, an increase in amylase is observed only in every fifth patient, and the level of lipase is observed in no more than half of the patients. Therefore, the determination of serum elastase is an important diagnostic criterion when determining pancreatitis in patients admitted to the clinic a week later or later from the onset of the first clinical symptoms.

Stool analysis

Analysis of feces for pancreatitis allows you to determine in what functional state the pancreas is. With a decrease in the secretion of digestive enzymes, the process of digestion of fats suffers first of all. These changes are visible in the feces. About broken exocrine function the pancreas is indicated by the following symptoms:

• the presence of fat in the feces;
• the presence of undigested food residues in the feces;
• when the bile ducts are blocked, the feces will be light.

Changes in feces, which occur with a pronounced violation of the exocrine function of the pancreas, are observed even with the naked eye. Feces have a shiny surface, poorly washed off the walls of the toilet. The stool is loose and loose. The smell of stool is strong and unpleasant. The reason for its appearance is the decay of undigested proteins in the intestine.

But it should be said that for determining the exocrine function of the pancreas, the analysis of feces is of minimal importance. For this purpose, other diagnostic methods are usually used. Most often, to determine disorders in the work of the pancreas, a probe is inserted and pancreatic juice is taken for analysis.

Other tests to determine pancreatitis

A wide variety of laboratory tests are used to diagnose pancreatitis. Here is a list of some of them:

1. Determination of immunoreactive trypsin... This method is used infrequently, since its specificity is only 40%. This means that in 60% of cases, a positive test for immunoreactive trypsin indicates not pancreatitis, but another disease, for example, cholecystitis, renal failure or hypercortisolism.
2. Determination of blood concentration of trypsin inhibitors... The lower their amount in plasma, the more pronounced the destruction of the pancreas. Therefore, the worse is the prognosis for this disease.
3. Determination of the content of trypsinogen in urine... The method is quite informative, sensitive and highly specific. It allows you to make a diagnosis with almost 100% guarantee. But it is used very rarely due to the high cost.

In combination with instrumental methods diagnostics and clinical manifestations inflammation of the pancreas, laboratory tests can quickly determine pancreatitis. There are a lot of them, but the greatest value for a doctor is given by determining the level of enzymes in the blood: on the first day - pancreatic amylase, after a few days - lipase and elastase.

Attention! The articles on our website are for informational purposes only. Do not resort to self-medication, it is dangerous, especially for diseases of the pancreas. Be sure to consult your doctor! You can make an online appointment with a doctor through our website or find a doctor in the catalog.