The LDH to AST ratio as an indicator of pancreatic necrosis in acute biliary and alcoholic pancreatitis.
- Author:
Jung Han KIM
1
;
Chang Uck KIM
;
Hyun Joo JANG
;
Won Jong BAHK
;
Jin Cheol PARK
;
Seung Sick KANG
;
Sea Hyub KAE
;
Jin LEE
;
Yong Bum KIM
;
Sang Aun JOO
Author Information
1. Department of Internal Medicine, College of Medicine Hallym University, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Acute biliary pancreatitis;
Acute alcoholic pancreatitis;
Pancreatic necrosis;
LDH, LDH/AST ratio
- MeSH:
Alcoholics*;
Humans;
L-Lactate Dehydrogenase;
Necrosis*;
Pancreatitis, Alcoholic*;
Plasma;
Tomography, X-Ray Computed
- From:Korean Journal of Medicine
2000;58(2):161-169
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Lactate dehydrogenase (LDH) has been reported to be a sensitive indicator of pancreatic necrosis (PN), and some studies suggested that an elevation of the ratio of LDH to AST (LDH/AST ratio) woud be more accurate indicator of PN in acute biliary pncreatitis (BP). However, there were no studies in alcoholic pancreatitis (AP). The aim of this study was to assess the clinical usefulness of LDH/AST ratio in alcoholic pancreatitis (AP) as a indicator of PN. METHODS: On the basis of CT scan findings, the patients were categorized into two groups as having PN or non-PN. The plasma levels of the LDH, AST and LDH/AST ratio over two weeks postadmission period were evaluated and compared with in two groups of patients with BP (consiting of 12 PN and 34 non-PN patients), and with AP (consisting of 14 PN and 38 non-PN patients). RESULTS: In acute BP, on post-admission days 1 and 2, the LDH/AST ratio were low in both groups without significant difference. In the group with PN, thereafter, the LDH/AST ratio increased gradually, reached peak values at the 7th days and decreased. In the non-PN patients, the LDH/AST ratio increased gradually, but remained below the control range. The LDH/AST ratios were significantly higher from post-admission day 3 in the group with PN than in the non-PN group. In acute AP, the LDH levels were significantly higher over two weeks from admission day in the PN patients. The LDH/AST ratios were remained within or below the control range in both groups, though with statistically significnat difference. CONCLUSION: The LDH/AST ratio could be used as an indicator of PN in acute BP. In acute AP, however, LDH was a more useful indicator from the early stage in the course.
