Analysis of the urine for the concentration of alpha-amylase (diastase) is a diagnostically valuable method for verifying the diagnosis of pancreatitis.
The urine diastase norm in adults with pancreatitis is in the range of 10 to 128 units / l. In pathological processes, diseases involving a change in the concentration of pancreatic enzymes, the concentration of diastase increases several times.
What is alpha amylase (diastase)?
Diastase is a protein synthesized by the pancreas (PZHZH) and has enzymatic abilities. In addition to PZHZH, diastasis is produced by cells of the salivary glands.
The main prerogative of diastase is the biodegradation of polysaccharides (ex. Starch) to monosaccharides. (glucose) for its absorption by the body. The level of diastase in urine sediment is a valuable indicator for the diagnosis of PZHZh pathologies.
Acute pancreatitis leads to an increase in diastase. Severe surgical pathology, which is accompanied by damage to the pancreatic cells, due to the release into the blood of a huge number of pancreatic enzymes. Since diastase is small, it is able to penetrate the renal filter. Thus, urinary diastasis increases with pancreatitis.
An increase in its concentration is observed in the following cases:
- Exacerbation of chronic pancreatitis, with the relapse of the disease often increase in alpha-amylase in the blood and, accordingly, in the urine;
- Pancreatic cancer is a serious cancer with an unfavorable prognosis, in most cases this disease affects the blood and urine diastase index;
- Pancreatonecrosis is an acute resuscitation, often fatal;
- Metabolic disorders, including diabetes mellitus;
- Acute abdominal surgical pathology: inflammation of the appendix, gallbladder, gynecological (including tubal pregnancy) or urological pathology;
- Alcohol intoxication - spirits have a pancreatic effect and have a detrimental effect on the tissue of the organ;
- PZhZh trauma;
In addition, the increase in the concentration of diastase results from the presence in the patient's body of mumps.
Diagnosis of pancreatic pathology
Urinalysis for pancreatitis, or suspicion of it, should be carried out as soon as possible in order to avoid the transition to the necrotic stage.
Urinalysis for pancreatitis is the first research in the diagnosis.
But to make a correct diagnosis, it is important to conduct a number of other studies.
For this purpose, the following studies are conducted:
- Protein. It is very important to determine the protein in the urine with pancreatitis in order to exclude nephrotic syndrome. Since diastasis can contribute to the staining of urine components, red urine in case of pancreatitis is not uncommon. Often, the dark color of urine misleads not only the patient, but also an experienced doctor.
- A blood test will determine the level of the fall of hemoglobin and red blood cells (red blood cells), due to bleeding from the eroded vessels of the diseased organ. In addition, the number of leukocytes and ESR in pancreatitis increases, which indicates the presence of inflammation. Also, according to the general blood analysis, it is possible to judge the ratio of the formed elements and the plasma.
- Biochemical blood analysis reveals an increase in the concentration of elastase, trypsin and other PZHZh enzymes, hypoglycemia, and a decrease in the level of blood proteins. Sometimes the level of bilirubin increases in patients, which indirectly indicates the pathology of the pancreas. The growth of this pigment also often leads to the initially incorrect diagnosis of cholecystitis or hepatitis.
- Analysis of feces for the presence of undigested lipids, fibers, protein cords. Changes in the faeces are associated with a violation of the enzymatic function of the pancreas and involvement in the process of the liver and gallbladder. There is a place to be steatorrhea.
The secondary methods of diagnosing pathology include MRI, immunological tests with the detection of various antibodies, CT diagnosis, ultrasound.
Etiology of increasing concentration of diastase in PJV pathology
If there are suspicions about the development of pathologists in the pancreas, first of all, the specialist sends the patient for a urine test.
Normally, enzymes formed in the exocrine part of an organ are activated only in the duodenal cavity. In pathology, activation of the enzyme, including diastase, begins in the ducts of the pancreas. Thus, the active substances begin to "self-digest" the body. Pancreatocytes are destroyed - the active protein enters the systemic circulation.
In this regard, a very informative method is to measure the concentration of enzymes in the blood and urine, namely diastase. With this "surge" the level of diastase increases hundreds of times.
A general clinical study of urine is being carried out, since this method is more accessible and easier to carry out, with pancreatitis in urinalysis an increase is observed according to the values of blood diastase. Decoding such studies is not difficult, but it should be borne in mind that different laboratories give different reference values.
The concentration of diastase can also have iatrogenic etiology, that is, due to the intake of certain drugs.
These substances include:
- Tetracycline antibiotics increase the enzymes in the blood and the appearance of dark urine sediment, which can affect the misdiagnosis of the diagnosis. The physician is obliged to warn patients who are being treated for an infectious pathology.
- Alpha-blockers (epinephrine, norepinephrine) are used in the treatment of shocks of various etiologies. Since this group of drugs is tropic to all the group of alpha blockers, the increase in diastase when they are administered is a transient state.
- Cytotoxic drugs and other drugs used to treat cancer patients. This group of drugs is chemotherapeutic agents and has a huge range of side effects, including a negative effect on pancreatic cells and pancreatic juice.
In addition, NSAIDs are used. This group of drugs is widely known to all - it is non-narcotic analgesics or nonsteroidal anti-inflammatory drugs.
These include Analgin, Nimesil, Diclofenac, Ibuprofen and many others. Almost every adult and child drinks a large amount of these drugs in their lifetime and do not think about their possible side effects. Starting from the negative effect on the gastric mucosa, ending with necrotic inflammation in the cells of the pancreas.
Rules for collecting analysis for diastase
The first rule of successful research is timeliness. In the event of pain of a shingles nature, a symptom of the Resurrection or other characteristic signs, the patient should immediately consult a doctor. A competent doctor in the event of suspicion of acute processes, first of all, send his patient to a urine test for the PZhZh enzyme.
The collection container must be sterile and with a tight-fitting lid. A laboratory technician needs a small amount of biological fluid for analysis. It is important to begin the study immediately after receiving the sample - as the enzymes are not resistant substances. Also, to confirm the authenticity of the data, the serum of the enzyme is examined. It is best to pass the analysis early in the morning.
An expert in the video in this article will tell you about the analysis of urine for diastase.