lipase-pancreas (LH Indholdsside)

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      <HtmlField Name="PageContent"><![CDATA[<h2>Resum&eacute;</h2>
<ul>
    <li>Lipase er et enzym, som katalyserer spaltningen af tri- og diglycerider til monoglycerider og fedtsyrer</li>
    <li>Det dannes i pancreas, hvor koncentrationen er meget h&oslash;j sammenlignet med blodbanen</li>
    <li>Ved akut pancreatitis frigives store m&aelig;ngder lipase til blodbanen og et niveau st&oslash;rre end 3 gange &oslash;verste referenceinterval er et af de laboratoriem&aelig;ssige diagnostiske kriterier for akut pancreatitis&nbsp;</li>
</ul>
<h2>Definition</h2>
<ul>
    <li>Koncentrationen af lipase i plasma, m&aring;lt som enheder (units) af dets katalytiske aktivitet per liter (U/L)<a href="https://wjes.biomedcentral.com/articles/10.1186/s13017-019-0247-0" data-type="other-reference" data-value="2019 WSES guidelines for the management of severe acute pancreatitis" data-url="https://wjes.biomedcentral.com/articles/10.1186/s13017-019-0247-0" title="2019 WSES guidelines for the management of severe acute pancreatitis">1</a></li>
    <li>Enzymet er i familie med lipoproteinlipase, som produceres i muskel og fedtv&aelig;v, og med hepatisk lipase</li>
</ul>
<h2>Synonymer</h2>
<ul>
    <li>Synonymer: Lipase, pancreaslipase, tributyrase, tiglyceridlipase, Triacylglycerollipase,&nbsp;</li>
</ul>
<h2>Indikationer&nbsp;<a href="https://wjes.biomedcentral.com/articles/10.1186/s13017-019-0247-0" data-type="other-reference" data-value="2019 WSES guidelines for the management of severe acute pancreatitis" data-url="https://wjes.biomedcentral.com/articles/10.1186/s13017-019-0247-0" title="2019 WSES guidelines for the management of severe acute pancreatitis">1</a>,<a href="EditorPage.aspx?da=core&amp;id=%7BF9C3EE18-F851-476B-8524-4CAD7D8C5549%7D&amp;ed=FIELD8091167745&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H8091176821&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Mederos MA, Reber HA, Girgis MD, Acute Pancreatitis: A Review. JAMA 2021;325: 382-390" data-value-piped="Mederos MA, Reber HA, Girgis MD|Acute Pancreatitis: A Review.|JAMA|2021|325|382-390|33496779" data-url="reference-link" data-pubmedid="33496779" title="Mederos MA, Reber HA, Girgis MD, Acute Pancreatitis: A Review. JAMA 2021;325: 382-390">2</a></h2>
<ul>
    <li>Supplement til amylase ved mistanke om akut pankreatit</li>
    <li>Analysen udf&oslash;res kun p&aring; f&aring; danske laboratorier, da&nbsp;<a href="~/link.aspx?_id=142A3BB818AE4E1C8379B4D8C49CC544&amp;_z=z">amylase</a>&nbsp;prim&aelig;rt anvendes p&aring; den n&aelig;vnte indikation, og de fleste steder m&aring;ler det pankreasspecifikke isoenzym</li>
    <li>Lipase er imidlertid mere specifik for akut pankreatit end amylase, da der kun sj&aelig;ldent ses klart forh&oslash;jede v&aelig;rdier ved andre tilstande med peritonit, fx perforeret ulcus eller perforeret appendicit<a href="EditorPage.aspx?da=core&amp;id=%7BF9C3EE18-F851-476B-8524-4CAD7D8C5549%7D&amp;ed=FIELD9207350061&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H9207350220&amp;us=sitecore%5Canvi&amp;mo&amp;pe=0&amp;fbd=1" data-type="book-reference" data-value="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH. Lyngbyes laboratoriemedicin. 2 udg.. København: Nyt Nordisk Forlag Arnold Busck A/S; 2010" data-value-piped="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH|Lyngbyes laboratoriemedicin. 2 udg.|København|Nyt Nordisk Forlag Arnold Busck A/S|2010" data-url="reference-link" title="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH. Lyngbyes laboratoriemedicin. 2 udg.. København: Nyt Nordisk Forlag Arnold Busck A/S; 2010">3</a>,<a href="EditorPage.aspx?da=core&amp;id=%7BF9C3EE18-F851-476B-8524-4CAD7D8C5549%7D&amp;ed=FIELD9207350061&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H9207350220&amp;us=sitecore%5Canvi&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Lippi G , Valentino M , Cervellin G, Laboratory diagnosis of acute pancreatitis : in search of the Holy Grail. Crit Rev Clin Lab Sci 2012;49: 18-31" data-value-piped="Lippi G , Valentino M , Cervellin G|Laboratory diagnosis of acute pancreatitis : in search of the Holy Grail|Crit Rev Clin Lab Sci|2012|49|18-31" data-url="reference-link" title="Lippi G , Valentino M , Cervellin G, Laboratory diagnosis of acute pancreatitis : in search of the Holy Grail. Crit Rev Clin Lab Sci 2012;49: 18-31">4</a></li>
    <li>Eventuelt som supplement til&nbsp;<a href="~/link.aspx?_id=142A3BB818AE4E1C8379B4D8C49CC544&amp;_z=z">amylase</a>&nbsp;ved mistanke om&nbsp;<a href="~/link.aspx?_id=F61E1F9A4D594FCF8DDAC06DEFC9A759&amp;_z=z">kronisk pankreatitis</a>, men v&aelig;rdien af en ekstra test er ikke stor<a href="EditorPage.aspx?da=core&amp;id=%7BF9C3EE18-F851-476B-8524-4CAD7D8C5549%7D&amp;ed=FIELD9207350061&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H9207350220&amp;us=sitecore%5Canvi&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Lippi G , Valentino M , Cervellin G, Laboratory diagnosis of acute pancreatitis : in search of the Holy Grail. Crit Rev Clin Lab Sci 2012;49: 18-31" data-value-piped="Lippi G , Valentino M , Cervellin G|Laboratory diagnosis of acute pancreatitis : in search of the Holy Grail|Crit Rev Clin Lab Sci|2012|49|18-31" data-url="reference-link" title="Lippi G , Valentino M , Cervellin G, Laboratory diagnosis of acute pancreatitis : in search of the Holy Grail. Crit Rev Clin Lab Sci 2012;49: 18-31">4</a></li>
</ul>
<h2>Fortolkninger</h2>
<h3>Forh&oslash;jede v&aelig;rdier<a href="https://wjes.biomedcentral.com/articles/10.1186/s13017-019-0247-0" data-type="other-reference" data-value="2019 WSES guidelines for the management of severe acute pancreatitis" data-url="https://wjes.biomedcentral.com/articles/10.1186/s13017-019-0247-0" title="2019 WSES guidelines for the management of severe acute pancreatitis">1</a></h3>
<ul>
    <li><a href="~/link.aspx?_id=5022C6009DAA4F739414DE007C6B5F16&amp;_z=z">Akut pankreatitis&nbsp;</a>
    <ul>
        <li>3 gange over &oslash;vre gr&aelig;nse i referenceintervaller, men ofte meget h&oslash;jere&nbsp;<a href="EditorPage.aspx?da=core&amp;id=%7BF9C3EE18-F851-476B-8524-4CAD7D8C5549%7D&amp;ed=FIELD8091167745&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H8091169558&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Mederos MA, Reber HA, Girgis MD, Acute Pancreatitis: A Review. JAMA 2021;325: 382-390" data-value-piped="Mederos MA, Reber HA, Girgis MD|Acute Pancreatitis: A Review.|JAMA|2021|325|382-390|33496779" data-url="reference-link" data-pubmedid="33496779" title="Mederos MA, Reber HA, Girgis MD, Acute Pancreatitis: A Review. JAMA 2021;325: 382-390">2</a>&nbsp;,&nbsp;</li>
        <li>Stigningen sker indenfor 4-8 timer efter symptomdebut. Maksimale v&aelig;rdier ses efter 1-2 d&oslash;gn og kan v&aelig;re 10-50 gange over &oslash;vre reference gr&aelig;nse</li>
        <li>Gradvis normalisering efter 1-2 uger</li>
    </ul>
    </li>
    <li>Risikofaktor for udvikling af alvorligt forl&oslash;b med infekti&oslash;s pankreas nekrose&nbsp;<a href=" " data-type="journal-reference" data-value="Li W, Ou L, Fu Y, Chen Y, Yin Q, Song H, Risk factors for concomitant infectious pancreatic necrosis in patients with severe acute pancreatitis: A systematic review and meta-analysis. Clin Res Hepatol Gastroenterol 2022;46: 101901" data-value-piped="Li W, Ou L, Fu Y, Chen Y, Yin Q, Song H|Risk factors for concomitant infectious pancreatic necrosis in patients with severe acute pancreatitis: A systematic review and meta-analysis.|Clin Res Hepatol Gastroenterol|2022|46|101901|35304319" data-url="reference-link" data-pubmedid="35304319" title="Li W, Ou L, Fu Y, Chen Y, Yin Q, Song H, Risk factors for concomitant infectious pancreatic necrosis in patients with severe acute pancreatitis: A systematic review and meta-analysis. Clin Res Hepatol Gastroenterol 2022;46: 101901">5</a>&nbsp;&nbsp;</li>
    <li><a href="~/link.aspx?_id=F61E1F9A4D594FCF8DDAC06DEFC9A759&amp;_z=z">Kronisk pankreatitis</a>, is&aelig;r med obstruktioner i ductus&nbsp;<a href="https://www.dsgh.dk/images/Guidelines/pdf/Kronisk_Pankreatitis_2.pdf" data-type="other-reference" data-value="Diagnostik og behandling af kronisk pankreatitis" data-url="https://www.dsgh.dk/images/Guidelines/pdf/Kronisk_Pankreatitis_2.pdf" title="Diagnostik og behandling af kronisk pankreatitis">6</a></li>
    <li>Efter<a href="~/link.aspx?_id=AF12D4D5F68240DA9AF7278FED497A12&amp;_z=z">&nbsp;ERCP</a></li>
    <li><a href="~/link.aspx?_id=5E179A64BD87496DB67E5B4511436E72&amp;_z=z">Pankreaskr&aelig;ft</a></li>
    <li>Forh&oslash;jede v&aelig;rdier kan ogs&aring; ses ved nyreinsufficiens, appendicitis, akut cholecystitis, diabetisk ketoacidose og virushepatit</li>
</ul>
<h3>Lave v&aelig;rdier</h3>
<ul>
    <li><a href="~/link.aspx?_id=4AF69BE2DC654560A3C10662691E6436&amp;_z=z">Cystisk fibrose</a></li>
    <li><a href="~/link.aspx?_id=F61E1F9A4D594FCF8DDAC06DEFC9A759&amp;_z=z">Udbredt kronisk pankreatitis</a></li>
</ul>
<h2>Fejlkilder (og kilder til normal variation)</h2>
<ul>
    <li>Lipase kan ogs&aring; ses forh&oslash;jet ved andre sygdomme</li>
</ul>
<h2>Biokemisk baggrund<a href="EditorPage.aspx?da=core&amp;id=%7BF9C3EE18-F851-476B-8524-4CAD7D8C5549%7D&amp;ed=FIELD9207350061&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H9207350220&amp;us=sitecore%5Canvi&amp;mo&amp;pe=0&amp;fbd=1" data-type="book-reference" data-value="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH. Lyngbyes laboratoriemedicin. 2 udg.. København: Nyt Nordisk Forlag Arnold Busck A/S; 2010" data-value-piped="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH|Lyngbyes laboratoriemedicin. 2 udg.|København|Nyt Nordisk Forlag Arnold Busck A/S|2010" data-url="reference-link" title="Lyngbye J, Kjær A, Ladefoged SA, Nissen PH. Lyngbyes laboratoriemedicin. 2 udg.. København: Nyt Nordisk Forlag Arnold Busck A/S; 2010">3</a></h2>
<ul>
    <li>Hovedparten dannes i de eksokrine, acin&aelig;re pancreasceller og en mindre del i ventrikel, tarm og lunger</li>
    <li>Koncentrationen i pancreasv&aelig;v er 20.000 gange h&oslash;jere end i blodet</li>
    <li>Pancreaslipase er et enzymatisk glycoprotein, som katalyserer spaltning af triglycerid til fedtsyrer og monoacylglyceroler </li>
    <li>Det udskilles&nbsp;sammen med andre enzymer til duodenum&nbsp;under ford&oslash;jelsen&nbsp;og spiller derfor en central rolle i fedtabsorptionen</li>
    <li>Det nedbrydes af chymotrypsin i tyndtarmen. Lipase i blodet filtreres frit i nyrernes glomeruli og nedbrydes i tubuli&nbsp;</li>
    <li>Halveringstiden i plasma er 7 - 13 d&oslash;gn</li>
</ul>
<h2>Pr&oslash;vetagning</h2>
<ul>
    <li>Veneblodpr&oslash;ver</li>
    <li>Pr&oslash;vetagningsr&oslash;r med heparin (til plasma) eller r&oslash;r uden antikoagulans (til serum)</li>
    <li>Afpipetteret plasma eller serum er holdbart i 3 d&oslash;gn ved stuetemperatur og 1 uge ved 4<sup>o</sup>C</li>
</ul>
<h2>Referenceintervaller</h2>
<ul>
    <li>Der kan v&aelig;re forskelle i de angivne intervaller fra laboratorium til laboratorium, b&aring;de afh&aelig;ngigt af de anvendte m&aring;lemetoder og referencepopulationen. Typiske&nbsp;v&aelig;rdier er:&nbsp;</li>
    <li>Voksne
    <ul>
        <li>Voksne:&nbsp; 13 - 60 U/L</li>
    </ul>
    </li>
    <li>B&oslash;rn og unge
    <ul>
        <li>0 - 12 &aring;r:&nbsp; &lt; 34 U/L</li>
        <li>13 - 17 &aring;r: &lt; 55 U/L</li>
    </ul>
    </li>
</ul>
<h2>NPU-koder og -navne</h2>
<ul>
    <li>
    NPU57165</li>
</ul>
<h3>Navne</h3>
<ul>
    <li><strong>Langt navn</strong>
    <ul>
        <li>P&mdash;Triacylglycerollipase; kat.k. = ? U/l</li>
    </ul>
    </li>
    <li><strong>Kort navn</strong>
    <ul>
        <li>Lipase;P</li>
    </ul>
    </li>
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