Participates in the breakdown of polysaccharides (starch, glycogen, etc.) to glucose, maltose and dextrins.

Synonyms:
Diastasis
1,4-a-D-glucan hydrolase
Serum amylase
Blood amylase
Amylase total
Total alpha amylase

Designation in analyzes:
Amy
alpha-amylase
AML
diastase
serum amylase
blood amylase

Main producers alpha-amylases:

• Pancreas
• Salivary glands (parotid, sublingual, submandibular, minor)

In a smaller amount this enzyme is found in the appendages of the uterus, intestines, lungs, muscle and adipose tissue, kidneys and liver.

Alpha-amylase functions in the oral cavity and intestinal tract.

In a healthy person, it enters the blood in very small quantities, as a result of the normal physiological renewal of the cells of the organs listed above.

Total or serum alpha-amylase in the blood is represented by two isoenzymes:

• Pancreatic alpha-amylase (P-type) ≈40%
• Salivary alpha-amylase (S-type) ≈60%

In pathological conditions associated with damage to the tissues of the pancreas, the total amylase in the blood increases due to an increase in
pancreatic P-alpha-amylase.

In diseases of the salivary glands, total serum amylase increases due to the fraction of salivary S-alpha-amylase.

In the vast majority of cases, an increase in the activity of total amylase in the blood is associated with pancreatic disease. Therefore, the analysis of amylase isoenzymes (P- or S-) is carried out according to special indications: to confirm the diagnosis of "pancreatitis"; for differential diagnosis of pathology of the pancreas, salivary glands, ovaries, fallopian tubes, lungs, etc.

The alpha-amylase molecule is small, so it is well filtered from the blood by the kidneys. With an increase in the enzyme in the blood, its content in the urine also increases.

Alpha-amylase in the blood - the norm in women and men

The average rate of total alpha-amylase in the blood of adult women and men is the same

Amylase in the blood - the norm in women and men by age
/table/

In newborns, children under one year old, the synthesis of a-amylase is insignificant, therefore the content of the enzyme in the blood is 2-5 times less than in adults. As complementary foods are introduced and the digestive system develops, amylase synthesis increases, and the level of the enzyme in the blood gradually reaches “adult” values.

The norm of total amylase in the blood in women and men by age Pancreatic amylase - the norm in women by age

/ For a more accurate interpretation, refer to local laboratory standards. Methods for determining the activity of amylase in the blood are different /

When is an amylase test needed?

Indications for carrying out
blood test for a-amylase:

• Sharp pain in the abdomen.
• Diagnosis of acute diseases of the pancreas.
• Evaluation of the effectiveness of the treatment of pancreatic pathology (including cancer).
• Differential diagnosis of diseases of the gastrointestinal tract.
• Parotitis (inflammation of the parotid salivary glands).
• Cystic fibrosis.

Greatest value blood test for total amylase - diagnosis of the cause of acute abdominal pain.

Clinical Significance Serum amylase analysis – detection and management of acute pancreatic disease. The main reasons for the increase
total alpha-amylase in the blood:

– Acute pancreatitis
- Abdominal injury
- Peritonitis
- Chronic pancreatitis
Tumor, cyst or cancer of the pancreas
- Acute cholecystitis, including calculous
- Acute infectious hepatitis
- Perforation of gastric ulcer
- Acute circulatory disorders of the abdominal organs, intestinal infarction
- Intestinal obstruction, intestinal perforation
- kidney failure
- Crohn's disease
- Mumps
– Macroamylasemia
- Ectopic pregnancy
- Ovarian pathology, salpingitis
- Diabetic ketoacidosis

It is obvious that an increase in the activity of total α-amylase in the blood is observed not only in the pathology of the pancreas. But an increase in the indicator by 3-5 times almost always has a pancreatic origin.

A marked elevation of 10-fold or more in serum alpha-amylase with severe abdominal pain suggests acute pancreatitis*. * Pancreatitis - inflammation of the pancreas

Pancreatitis - why does alpha-amylase increase in the blood?

The pancreas (pancreas) is a small organ of the abdominal cavity, pale yellow in color, up to 15 cm in length, weighing approximately 100 g. It is located behind the stomach.

Up to 10% of pancreatic tissue produces pancreatic hormones (insulin, glucagon, and somatostatin).

Up to 90% of the organ mass is represented by acinar tissue producing pancreatic juice. It includes: electrolytes dissolved in water and three groups of digestive enzymes:

• Amylases (active) - break down carbohydrates.
• Lipases (active) - digest fats.
• Proteolytic enzymes or proteases (in an inactive form) - normally, proteases are activated only in the intestine, where digestion (proteolysis) of food proteins occurs.

Pancreatic juice is collected in the central (Wirsung) duct of the pancreas. Then it flows into the common bile duct and (together with bile) is collected in the hepatic-pancreas (Vater) ampoule. The entry of the "digestive mixture" into the duodenum regulates the sphincter of Oddi.

Normally, pancreatic proteases are activated (trypsinogen to trypsin, etc.) and exhibit their aggressive "digesting" properties exclusively in the cavity of the small intestine.

As a result of mechanical injury, blockage of the excretory ducts, or under the influence of alcohol, the pancreatic tissue is damaged, inflamed, and swollen. The membranes of acinar cells become hyper-permeable. Pancreatic enzymes “leak out”, are immediately activated and evade into the blood, destroying (self-digesting) pancreatic tissue.

• Acute pancreatitis- this is an inflammatory-destructive lesion of the pancreas as a result of the activation of pancreatic proteases within the pancreas itself.

Acute pancreatitis is accompanied by a massive release into the bloodstream of all "pancreatic" enzymes, including lipase.

It is lipase that is a strictly specific indicator of the destruction of the pancreas: if its level is elevated, the diagnosis of "pancreatitis" is beyond doubt.

The main causes of acute pancreatitis:
1. Alcohol abuse
2. Gallstone disease

Other reasons:
- Infections (viral, bacterial).
- Injuries to the pancreas as a result of a strong blow to the stomach (during a fall, fight, etc.)
- Pathological changes in the area of ​​the common bile duct, the papilla of Vater, the sphincter of Oddi (reflux of bile into the pancreatic ducts).
– Diseases of the duodenum (duodenitis, etc.)
- Helminthiasis.
- Inflammatory diseases of the liver and biliary tract.
- Acute circulatory disorders in the vessels of the pancreas: thromboembolism, prolonged spasm, blockage by fat droplets or atherosclerotic plaques, etc.
- Toxic poisoning (mercury, arsenic, phosphorus, etc.) or drug damage to pancreatic tissues.

The first symptoms of acute pancreatitis are
sudden sharp pain in the upper abdomen (epigastrium) or in the navel. The pain may radiate to the back, left hypochondrium, left shoulder and shoulder blade. Sometimes the pain captures a wide strip from the hypochondrium to the hypochondrium, it is girdle. The pain may be accompanied by repeated vomiting that does not bring relief, distension in the abdomen, flatulence, belching, fever. Appetite is absent, the chair is more often detained.

The pain subsides somewhat in the sitting position, lying on the stomach or bending over on the left side.

How does the level of a-amylase in the blood change in acute pancreatitis

If the levels of serum a-amylase after an acute attack of pancreatitis do not return to normal for a long time, the development of a pancreatic pseudocyst is assumed.

An increase and then a rapid decrease in high levels of a-amylase and other digestive enzymes in the blood in acute pancreatitis is a poor prognostic sign. In 20% of cases, acute pancreatitis is very severe and is a life-threatening condition.

Increased alpha-amylase in the blood in chronic pancreatitis

Chronic pancreatitis- This is a gradually developing, long-term inflammation of the pancreas. Sometimes it proceeds without acute attacks, almost asymptomatically.

In chronic pancreatitis, the activity of a-amylase in the blood and urine can be normal, elevated, or even low. Therefore, in this situation, the analysis of serum amylase activity is uninformative.

Used to diagnose chronic pancreatic diseases provocative tests(with prozerin, with glucose):
Normally, after the introduction of prozerin (or glucose intake), the level of a-amylase in the blood rises to 60% of the original.
In the pathology of the pancreas with severe secretory insufficiency, amylase in the blood increases by 30% of the initial value.

Increased a-amylase in pancreatic cancer

The activity of a-amylase in the blood and urine in malignant tumors of the pancreas may be slightly increased, may remain normal. This test is not used to diagnose pancreatic cancer.

Increased a-amylase in macroamylasemia

An isolated rise in serum α-amylase is an important diagnostic sign of rare benign macroamylasemia.

This condition is due to the binding of several molecules of a-amylase to plasma proteins. Due to their large size, "macroamylase" aggregates cannot pass through the glomerular membranes of the kidneys, and therefore accumulate in the blood.

Alpha-amylase in the blood of pregnant women

During pregnancy, blood amylase may be slightly increased. This does not contradict the permissible physiological norm.

Medicines that increase alpha-amylase in the blood:

Blood alpha-amylase is lowered - causes

An abnormal decrease in alpha-amylase in the blood is very rare and indicates a decrease in pancreatic function or damage to other external secretion glands associated with hereditary or infectious diseases.

A low blood amylase level has no clinical significance. In practice, it is important to interpret the high levels of the enzyme.

What is the danger of increasing a-amylase in the blood?

By itself, an increase in alpha-amylase in the blood is safe. But it is associated with inflammation of the pancreas and the entry of active proteases into the blood, which damage both the pancreas and, as a result, other organs.

Exceeding the normal values ​​of alpha-amylase in the blood more than 3 times- a marker of inflammation of the pancreas

As a result of evasion of active proteases, the level of kinins, histamine, and other bioactive substances in the blood increases. General microcirculatory disorders develop, collapse is possible.

What to do if pancreatic amylase is elevated

A significant increase in pancreatic amylase in the blood is an indication for hospitalization.

Prehospital activities aimed at eliminating pain and suppressing the activity of pancreatic enzymes.

Painkillers: Baralgin, Analgin, Tramal.

To eliminate spasm: Papaverine, Galidor, No-Shpa.

Antispasmodic anticholinergics: Buscopan, Metacin.

Normalization of the tone of the sphincter of Oddi: Duspatalin.

Inhibition of the activity of pancreatic enzymes: Kvamatel (famotidine).

Antihistamine, antiserotonin, edema-reducing drugs: Tavegil, Suprastin, Dimedro, Peritol.

In severe forms of acute pancreatitis, measures are taken in the intensive care unit. To reduce enzymatic toxemia on the first day of the disease, Kontrykal or other inhibitors of proteolysis are administered intravenously. Antibacterial therapy is prescribed.

After the acute situation subsides, pancreatic enzymes that do not contain bile are prescribed in an intermittent course of up to 3 months (2 weeks of admission, 10 days of withdrawal): Pancreatin, Mezim-forte, Creon, Pancitrate (1 tablet 3 times a day with meals) .

Diet to lower pancreatic amylase

In the first 1-2-3 days acute condition - hunger.

Then gradually introduce into the diet:
- pureed cereals on the water;
- slimy pureed soups on the water;
- milk;
- weak tea with crackers;
- omelette;
- cottage cheese;
- low-mineralized water without gas, 50-100 ml 5-6 times a day: Slavyanovskaya, Essentuki No. 4, Borjomi, Naftusya.

From the 7th day it is allowed:
- vegetable, potato puree;
- steam cutlets, boiled fish;
- White bread;
- baked apples, fruit puree.

During the recovery period, phytotherapy can be used (after consultation with the doctor).

Herbal remedy for pancreatitis
Potentilla goose - 1 tablespoon
Celandine - 1 tbsp. l.
Calendula - 1 tbsp. l.
Marshmallow root - 1 tbsp. l.

Brew 1 tablespoon of the collection with 1 cup of boiling water, heat in a water bath for 15 minutes. Sue. Take 1/3 cup 3 times a day 15 minutes before meals. Reception course: 1 month.

Diet No. 5P with increased amylase and pancreatitis

Basic principles supply:

• Avoid alcohol completely.
• Cook food for a couple or boil, chop.
• Meal mode: in small portions, 4-6 times a day.

What is prohibited?
Rich broths: meat, chicken, fish, vegetable, especially mushroom.
Hard boiled eggs, fried eggs.
Fatty meats, poultry, fish, game.
Pork fat, beef and mutton fat.
Raw: cabbage, radish, radish, sorrel, spinach, green onion.
Smoked meats, spices, spicy snacks, canned food, mushrooms, sausages.
Muffin, fresh pastries, black bread, ice cream, fatty desserts, cocoa, chocolate.
Alcohol in any form.

What to limit?
Fats: butter - 30 g, vegetable - 20 g per day.
Fast carbohydrates, sugar.
Coarse fiber, boiled (stewed) cabbage.
Too sour, sweet raw fruits.
Pastries, confectionery, coffee, strong tea.

What is allowed?
Dried white bread.
Boiled, stewed vegetables.
Any porridge, pasta.
Lean meat, poultry, fish (steam cutlets, meatballs, soufflés, rolls, etc.)
Eggs in the form of a protein omelet. Soft-boiled 1 piece per day.
Milk, non-sour cottage cheese, Dutch, Adyghe cheese.
Baked apples, fruit puree.
Rosehip broth, weak tea, kissels and compotes on xylitol.

The therapeutic diet is observed for at least 6 months. In the future, you should adhere to diet No. 5 according to Pevzner (watch the video).

How to donate blood for alpha-amylase

To determine the activity of alpha-amylase, blood is taken from a vein (5 ml)

In an acute condition, blood can be donated at any time.

With a planned analysis, blood is given in the morning, strictly on an empty stomach: do not eat, do not drink.

Do not smoke before donating blood.

Falsely elevated the results of a blood test for alpha-amylase may be in chronic renal failure, while taking the medications listed above.

Falsely low- Against the background of hypercholesterolemia (high cholesterol in the blood).

A slight isolated increase in alpha-amylase in the blood
is not sufficient reason to make a diagnosis.

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Blood amylase during diagnostic procedures can give an idea of ​​the state of the pancreas and salivary glands, since it is these glands that produce amylase. If we talk about pathologies, then the analysis for amylase is reliable for pancreatitis.

Seeing the term alpha amylase as a result of a blood test, one may wonder how simple amylase and alpha amylase relate to each other. In life, medicine deals with three types of amylases: alpha, beta and gamma.

Beta amylase is characteristic of bacteria and fungi, and also occurs in plants. Gamma amylase works in acidic environments at a pH of about 3. But alpha amylase is just “tuned” to the conditions that are maintained in the human body. In particular, it is active at a pH of about 7. Recall that in human blood, pH is maintained very strictly at the level of 7.4 with a very small deviation.

The human body is characterized by the work of one of the types of amylase. Without going into unnecessary details of the biochemical process, we note that we say alpha amylase, meaning human amylase, which is mostly identical (although there are nuances).

Functions

The pancreas (this type of amylase is one of the components of digestive juice) and salivary glands (the enzyme is secreted into the oral cavity by three pairs of glands) are responsible for the production of alpha-amylase. Amylase is active only in the gastrointestinal tract and under conditions of a narrow pH optimum (7.1).

The main function of amylase is the hydrolysis of starch.

The process of its enzymatic cleavage begins already in the oral cavity, under the action of salivary amylase. After the food reaches the stomach, the work of salivary amylase stops, since the pH of the stomach is 2-3 (under these conditions, the enzyme is inactive).

In people who like to "snack on the go", chewing food poorly, salivary amylase practically does not participate in the process of starch digestion. Therefore, its hydrolysis occurs mainly in the duodenum and jejunum, under the action of pancreatic alpha-amylase (PA).

Another point to consider is the time of activity. The fact is that alpha amylase is active during the day, since meals correspond to this time of day, but at night the body rests, and with it the digestive enzyme does not show activity.

Very important! Without chewing food properly, “snacking on the run”, allowing ourselves to go to the refrigerator at night, we thereby turn off alpha amylase from the process of digesting food. This is fraught with at least the development of pancreatitis.

Amylase in the blood

Amylase does not function in the blood. It is detected in the analysis in minimal quantities, as a result of the natural renewal of the cells of the pancreas and salivary glands. About 60 percent of the amylase circulating in the blood is salivary, the remaining forty is pancreatic amylase.

From the body, the enzyme is excreted mainly by the kidneys, with urine. Given the small size of the amylase molecule (compared to other enzymes), it freely passes through the renal glomeruli. In this regard, it can normally be found in the urine. The level of the enzyme in the urine increases with an increase in its levels in the blood.

Amylase test

Two days before the study, it is necessary to limit, and it is better to stop eating fatty, fried foods. For a day, strong tea and coffee are excluded.

The use of alcoholic beverages leads to a pronounced increase in alpha-amylase in the blood. If the examination is carried out as planned, it is advisable to refuse to take alcohol at least one week before the collection of material for analysis.

Also, treatment leads to an increase in amylase:

• non-steroidal anti-inflammatory drugs,
• preparations of gold
• captopril,
• furosemide,
• tetracycline antibiotics,
• administration of adrenaline and narcotic analgesics.

In women, an increase in the level of the enzyme may be due to the intake of estrogen-containing contraceptive tablets.

Important. For emergency indications (acute pancreatitis), the analysis is taken at any time. Also, its level is monitored in dynamics, since the enzyme index can change during the day (the indicators will depend on the severity of the disease).

The rate of amylase in the blood

During the study, the following is assessed:

• the total amount of alpha-amylase (salivary and pancreatic);
• the level of alpha-amylase of the pancreas.

The results of the study are recorded in units / l.

Norm of total alpha-amylase:

• in babies under two years old, it ranges from five to 65;
• from two to seventy years - from 25 to 125;
• in patients older than seventy years - from 20 to 160.

Indicators of pancreatic amylase:

• in babies up to six months, the amylase rate is less than 8;
• from six months to a year - up to 23;
• from one to ten years - up to the 31st;
• from 10 to eighteen years old - up to 39 years old;
• in patients older than eighteen years, the norm is up to 53.

Amylase levels for women and men are the same.

When to analyze

Attention. The amylase index is an important diagnostic indicator in the clinic of "acute abdomen".

With various pathologies of the pancreas (pancreatitis, obstruction of the pancreatic duct by a stone, metastasis or primary tumor), pancreatic amylase is released into the general circulation. It is important to understand that there is no increase in salivary alpha-amylase. In acute lesions of the pancreas, the activity of the pancreatic enzyme can be up to 90% of the total.

When interpreting the analyzes, it must be taken into account that an increase in the total activity of the enzyme with a decrease in the pancreatic amylase index indicates that pancreatic damage is unlikely. In such a situation, it is necessary to exclude the pathology of the intestines, ovaries, skeletal muscles (they also contain alpha-amylase, but in minimal quantities).

Most often, the analysis for alpha-amylase is carried out with:

• inflammation of the parotid gland (mumps-mumps or non-epidemic, due to obstruction of the duct of the gland with a stone, etc.);
• damage to the pancreas (acute and chronic, in the acute stage of pancreatitis, decompensated diabetes mellitus (ketoacidosis));
• differential diagnosis of the causes of "acute abdomen";
• viral infections;
• cystic fibrosis (cystic fibrosis of the pancreas).

Amylase is elevated. Causes

Most often, the enzyme increases with damage to the pancreas. Enzyme activity in acute pancreatitis can increase ten times from noma. In some cases, in patients, amylase in the blood may increase only slightly, or remain within normal limits.

This is due to the fact that there is no direct relationship between the severity of pancreatic tissue damage and the increase in amylase. Since as a result of massive destruction of the tissues of the organ, most of the cells that produce this enzyme die. Therefore, amylase can remain within the normal range.

In chronic pancreatitis, amylase first increases, and then, when a significant number of gland cells die, the level of the enzyme decreases.

Very important. If amylase decreases against the background of progression of clinical symptoms, this serves as a poor prognostic sign, as it indicates severe destruction of pancreatic tissue.

In patients with decompensated diabetes mellitus, amylase increases due to:

• ketoacidosis (due to high sugar levels);
• lesions (LJ).

Also, the causes of an increase in amylase in the analysis can be injuries, cysts and malignant tumors of the pancreas, metastatic organ damage, obstruction of the pancreatic duct with a stone (metastasis or primary tumor).

It is important to remember that amylase can also be elevated when:

• mumps;
• acute appendicitis;
• intestinal obstruction;
• intestinal ischemia;
• peritonitis;
• malignant tumors of the ovaries;
• AKI and CRF (acute and chronic renal failure);
• acute cholecystitis;
• ectopic pregnancy;
• TBI (traumatic brain injury);
• perforation of a stomach ulcer;
• alcohol intoxication;
• ruptured aortic aneurysm.

A rare cause of an increase in alpha-amylase is macroamylasemia. This disease is accompanied by the combination of amylase with large plasma proteins into macroamylase, which does not pass through the glomeruli of the kidneys (due to the large size of the compound) and, as a result, accumulates in the blood.

The exact causes of the disease are unknown, but chronic pancreatitis, long-term treatment with glucocorticosteroids and salicylates play the largest role in the pathogenesis of macroamylasemia.

When amylase is low

A low enzyme level is much less common than an elevated one. Such changes in the analysis are characteristic of pancreatic insufficiency, cystic fibrosis, severe liver damage (liver failure), pancreectomy (removal of the pancreas).

An increased level of cholesterol in the blood can lead to an underestimation of pancreatic amylase.

In children of the first year of life, the level of the enzyme is much lower than in adults. This is due to the fact that the food they receive is devoid of sufficient complex carbohydrates.

What is the danger of changing the level of the enzyme

In itself, the state when amylase is elevated does not have clinical consequences for the body, however, it is an important marker of pancreatic damage. If an increase in the enzyme index is detected, as a rule, the analysis is monitored during the day, which makes it possible to assess the dynamics of the pathological process.

A decrease in the level of the enzyme against the background of a deterioration in the patient's well-being indicates a severe destruction of the pancreatic tissue. You should pay close attention to the situation. It is simply necessary to annoy the doctor until the reasons are clear.

Very important. The salivary glands are to a lesser extent, but the pancreas is an extremely sensitive organ, easily subject to “breakage” with very serious consequences, up to death. The importance of the pancreas is emphasized by its supply of blood through two independent arteries.

The large molecules of polysaccharides that come with food cannot be absorbed into the blood unchanged, they must be broken down into simple sugars in order to enter the bloodstream and become an energy source for the cells of the body. Again, they cannot do this on their own, here they need substances that will be able to catalyze the reaction and help to cope with the task. Such an active substance is a digestive enzyme (enzyme) amylase, the main purpose of which is to break down complex carbohydrates into monosaccharides.

The main responsibility for the production of α-amylase lies with the pancreas, somewhat less it is produced by the salivary glands, which open into the oral cavity, where the digestion of carbohydrates begins. In addition, high amylolytic activity was observed in other organs: intestines, fallopian tubes, liver, adipose tissue, kidneys, and lungs. Carbohydrates, bypassing the stomach (they are not broken down there, salivary amylase is neutralized by the acidic environment of the stomach), enter the duodenum in order to reach the level of simple sugar - glucose under the action of enzymes (amylase, maltase, lactase). It should be noted that pancreatic amylase is more active than salivary amylase, and its abilities are higher: it can break down raw starch that has not been subjected to heat treatment. Having broken down into monosaccharides, complex sugars can thus overcome the capillaries of the intestinal villi and go to the liver through the portal vein (more than 50%), and also (less than half) spread through the cells of the body, delivering them an energy resource.

conversion of starch to glucose by amylase

Analysis for α-amylase

Such a biochemical indicator as amylase is very significant in the diagnosis of pancreatic diseases. Under normal conditions, the liquid part of the blood (plasma or serum) contains approximately 60% of the alpha-amylase produced by the salivary glands and about 40% of the enzyme synthesized directly by the pancreas (pancreatic alpha-amylase).

The activity of the enzyme depends on the time of day: during the daytime it increases, and at night it “dozes” along with the host, so people who run to the refrigerator at night are at great risk of earning pancreatitis. Amylase, mainly pancreatic, is excreted by the kidneys in accordance with the amount of urine excreted. The determination of the level of amylase in the blood serum and in the urine is of diagnostic importance, moreover, a urine test makes it possible to detect an acute inflammatory process in the pancreas at later stages.

Basically, the determination of alpha-amylase activity is used to detect inflammatory diseases of the pancreas, and the reliability of the results depends on how accurately the conditions for conducting a laboratory analysis are met:

• The patient donates blood from a vein on an empty stomach (preferably in the morning, given the daily fluctuations in enzyme activity). By the way, this rule applies to everyone.
• The taken material is quickly delivered to the laboratory, where it is immediately taken to work and tested for an hour (enzymes cannot stand idle). If the technical capabilities of the CDL do not allow meeting the allotted time, then the serum, after separating the clot, should be frozen.
• Urine should also be tested within an hour, otherwise it should be frozen for a longer time.

Of course, if all clinical manifestations indicate an acute attack of pancreatitis, then the analysis is taken without looking at the clock, because it is clear that such a condition will not endure until the morning.

Numerical values ​​of the enzyme in the results of the study

The values ​​of the norm of amylase in the blood can be found in different units, so in digital terms they will differ. Usually, when a patient is given an analysis form, the norms are entered in brackets next to the indicator, since different laboratories may use different reagents and methods, so we should not litter the text with various digital options. As for the norm of amylase in the blood in children, they differ from those in adults only up to 1 - 2 years, for the rest of the age categories the norms are identical, while they do not differ in any way in men and women. In this way, α-amylase activity in blood serum:

1. In children up to a year - up to 30 U / l or 10 - 25 g / (tsp);
2. In adults (regardless of gender) - up to 120 U / l or 16 - 36 g / (tsp).

Some differences from adults are observed in the urine of children:

• Up to a year - up to 105U / l;
• Up to 16 years - up to 160U / l;
• In adult men and women - up to 560 U / l, and in a portion taken from daily urine in adults, amylase activity should not exceed 360 U / day or 28.0 - 160.0 g / (h.l), the level of pancreatic amylase normally should not exceed 450 U/l.

Meanwhile, if the patient received the result of the tests on hand, but finds it difficult to understand the records, then he may inquire about the units of measurement and the methodology for conducting the study in the laboratory itself.

Pancreas response

Based on the norms of amylase in the blood and urine, after a laboratory test, it is possible to establish a diagnosis, in most cases, suspicions of pancreatitis are justified.

Changes in indicators in dynamics can have different options:

• From the onset of symptoms of the disease, the values ​​of alpha amylase grow rapidly and in 6 to 12 hours can exceed the maximum level of enzyme activity by 30 times;
• If everything goes well and the pancreas copes, then amylase will return to normal within 2 to 6 days;
• If the activity of amylase is increased for more than 5 days (days), then one can think that the inflammatory process continues to progress and may end total pancreatic necrosis.

Of course, amylase will also be increased in case of exacerbation of chronic pancreatitis, however, the process does not develop so rapidly and the enzymes behave more calmly.

Besides, the cause of an increase in pancreatic enzyme may be problems related to other organs:

• Peptic ulcer perforation can cause an inflammatory process in the pancreas;
• Epidemic parotitis, popularly called "mumps";
• Acute surgical diseases of the abdominal cavity (appendicitis, intestinal obstruction, peritonitis, etc.);
• (in case of acidosis);
• Severe renal dysfunction;
• Large doses of alcoholic beverages, taking hormones, drugs, diuretics, some antibiotics;
• Poisoning with methyl alcohol;
• The level of α-amylase can increase if the enzyme combines with immunoglobulins to form a complex ("macroamylase", noted in 2% of the inhabitants of the Earth), but this is a very rare cause.

Oddly enough, but for chronic pancreatitis without exacerbation, a cyst localized in the gland, and even a neoplastic process (cancer) that affects the gland, amylase reacts little and rises slightly and smoothly.

A decrease in the activity of amylase in the blood does not play a special role in the diagnosis of pathological conditions. It falls with pancreatic necrosis, thyrotoxicosis, inflammatory and tumor diseases of the liver, sometimes with toxicosis of pregnant women.

Clinicians note that an increase in the activity of the enzyme in the blood is accompanied by its parallel increase in the urine, however, when the process subsides, the picture changes somewhat: in the blood, amylase decreases, while in the urine it continues to remain at a high level for another week.

The process of digestion is the mechanical and chemical processing of food. Complex organic substances that a person receives with food are broken down into simple components. These biochemical reactions take place with the participation of digestive enzymes, which are catalysts. Amylase is an enzyme that breaks down complex carbohydrates. Its name comes from "amilon", which means "starch" in Greek.

Amylase functions

The breakdown of carbohydrates occurs in the oral cavity and duodenum. Amylase is a digestive enzyme that breaks down polysaccharides to oligosaccharides and then to monosaccharides. In other words, under the action of the active substance, complex carbohydrates (for example, starch) break down into simple components (for example, to glucose). A small amount of the substance is produced by the salivary glands, intestines, liver, kidneys, lungs, adipose tissue, fallopian tubes. The pancreas secretes most of the enzyme.

Polysaccharide molecules have a complex structure and are poorly absorbed by the small intestine. The process of digestion of complex carbohydrates (polysaccharides) under the action of amylase begins already when food enters the mouth, so starchy foods (potatoes, rice, bread) must be chewed thoroughly in order to be well moistened with saliva. This greatly facilitates their digestion by the initial section of the small intestine. Under the action of amylase, the metabolism of complex carbohydrates is accelerated, their absorption improves.

The enzyme has several names - α-amylase, diastase, pancreatic. There are varieties: alpha, beta, gamma. The human body synthesizes only alpha-amylase. This is a general indicator of a digestive enzyme. Pancreatic amylase is distinguished from it. It is produced by the pancreas, which belongs to the endocrine glands. Its hormones and enzymes enter not only the intestines, but also into the blood. A biochemical analysis of blood (or urine) determines two indicators: pancreatic and α-amylase.

Analysis for α-amylase

Violation of metabolic processes, inflammation of various origins cause changes in the composition of the blood. Blood amylase is mainly determined with suspicion of acute or chronic pancreatitis (inflammation of the pancreas). Attacks of the disease are accompanied by pain around the navel, nausea, vomiting, fever. Deviations from the norm of the level of the enzyme cause tumors, stones in the pancreatic ducts.

Enzyme indicators are violated in diabetes mellitus, hepatitis, mumps (mumps), inflammation of the abdominal cavity (or peritonitis). For biochemical analysis, venous blood is taken on a lean stomach in the morning. To obtain reliable results, you should not eat spicy and fatty foods, alcohol the day before. It is necessary to exclude physical and emotional overload.

In normal digestion, the liquid part of the blood contains about 60% alpha-amylase and 40% pancreatic. The activity of the enzyme is affected by the time of day. At night, amylase is less active, so those who eat at night have a high risk of developing pancreatitis. For the diagnosis of pathologies, determining the level of the enzyme in plasma and blood serum is of decisive importance. Pancreatic amylase is secreted by the kidneys, therefore, the analysis reveals manifestations of pancreatitis in the later stages.

Venous blood for testing is sent to the laboratory within an hour. To determine the enzyme level, a long idle time of the taken material is unacceptable. If there are no conditions for analysis after separation of the clot, the serum is frozen and tested later. Methods for determining the enzyme differ and depend on the reagent used, so the analysis form contains information about the established indicators and acceptable standards.

The dynamics of the enzyme level is of diagnostic importance. At certain stages of the disease, the amount of the enzyme can increase 30 times in 6-12 hours. After an acute condition, the indicators are normalized in 2-6 days. If for 5 days the enzyme parameters remain high, they indicate the progression of the inflammatory process and a high risk of developing total pancreatic necrosis.

Amylase rate

A biochemical blood test for enzyme content is performed by any biochemical laboratory. It shows the content of conventional units of the digestive enzyme in 1 liter of blood. The concentration of the substance depends on the age of the patient. The norm of the enzyme in the blood does not depend on gender:

Alpha-amylase is low in the blood

The tendency of the amylase concentration to zero is a normal state. This is an indicator that the digestive gland is able to control the level of the active substance. In practice, the content of the digestive enzyme is never zero, and it is always determined in a blood test. At values ​​below the established minimum limit, they speak of a decrease in the enzymatic activity of pancreatic cells.

Causes

Decreased levels of α-amylase are associated with serious diseases and pathological conditions. Deviation from the norm is caused by:

• Total pancreatic necrosis. Pathology is characterized by self-digestion of the pancreas.
• Oncology 4 stages. Normal pancreatic tissue is replaced by a malignant neoplasm.
• Cystic fibrosis. A hereditary disease in which the glands of external secretion are affected.
• Operations. During surgery, most of the pancreas was removed.

Alpha amylase is elevated

Minor deviations from the indicators of the normal range of values ​​with stable health are not evidence of pathological processes. With an increase in indicators by half or more, lesions of the pancreas and nearby organs occur. As a result, a large amount of the digestive enzyme will enter the systemic circulation.

Causes

The reasons for an increase (occurs more often than a decrease) in the amount of a digestive enzyme are as follows:

• Excessive secretion of pancreatic (or pancreatic) juice.
• Difficulty in the outflow of pancreatic juice into the duodenum.
• Increased release of digestive enzymes as a result of increased blood flow caused by inflammation of the pancreas and nearby organs.
• Injury to the tissues of the pancreas.
• Pancreatic necrosis.
• Acute and chronic pancreatitis.
• Tumors of the pancreas.
• Cholelithiasis.
• Parotitis.

Level in urine

Diastasis is amylase, which is determined in a urine test. In it, the concentration of the digestive enzyme is higher. The normal level for adults is 10-125 units / l, for children 10-64. For the reliability of the results on the eve, it is necessary to refrain from salty and spicy foods, alcohol, foods that change the color of urine (beets, carrots). The results distort narcotic analgesics, oral contraceptives, ibuprofen, corticosteroids.

An analysis for diastasis is prescribed for severe pain in the abdomen and back against the background of a lack of appetite, frequent vomiting, and fever. All pathological conditions and diseases that cause an increase in the enzyme in the blood automatically cause an increase in diastase. Among them:

Amylase is a biologically active enzyme produced mainly by the pancreas and, to a lesser extent, by the salivary glands. Role in the body - participation in metabolic processes associated with carbohydrates. Amylase is divided into two types - pancreatic amylase, which is produced by the pancreas, and alpha-amylase, or total body amylase. It breaks down starch into simple saccharides. Without alpha-amylase, the normal functioning of the digestive system of the body is impossible.

The norm of amylase in the blood. Result interpretation (table)

Before talking about the rate of amylase in the body, you need to understand what kind of amylase we are talking about. Alpha-amylase is a digestive enzyme necessary for the body, without which the breakdown of carbohydrates is impossible. Normally, its content is:

• in young children, up to 2 years - 5 - 65 U / l,
• older than 2 years and up to 70 - 25 - 125 U / l,
• in older people - 20 - 160 U / l.

Pancreatic amylase is a component of alpha-amylase. Usually its level is highlighted on a separate line. This enzyme is actively produced by the pancreas in the presence of some inflammatory processes in it. Therefore, the normal content of pancreatic amylase should be as follows:

• in newborns up to six months - less than 8 U / ml,
• from six months to 12 months - less than 23 U / ml,
• in persons older than 1 year - less than 50 U / ml.

Blood testing for amylase is usually ordered if a patient is suspected of having chronic or acute pancreatitis. Although changes in the concentration of this enzyme are quite characteristic of some other diseases. The rate of amylase in the blood is determined by biochemical analysis. Blood sampling for him is made from a vein, in the morning and on an empty stomach.

If amylase is elevated, what does it mean?

A smooth increase in the level of amylase in the blood occurs within a few hours from the onset of an attack of acute pancreatitis. After the attack ends, this indicator returns to normal again, but this takes several days. Acute pancreatitis can cause amylase levels to be as high as 5 or 6 times normal. However, if amylase is elevated, this does not always indicate pancreatitis, moreover, sometimes even during an attack and after it, amylase can remain within the normal range. Therefore, to make an accurate diagnosis, it is necessary to take into account other markers, for example, the level of lipase.

Other diseases that can cause an increase in the level of amylase in the blood:

• pancreatic cyst,
• malignant tumor of the pancreas,
• diseases of the biliary tract and gallbladder,
• chronic renal failure,
• inflammatory processes in other organs of the abdominal cavity,
• cystic fibrosis,
• alcohol intoxication,
• ectopic pregnancy,
• diabetes,
• parotitis,
• insufficient activity of the salivary glands, for example, if they are damaged.

Taking certain medications can also lead to a similar effect. Therefore, before taking a blood or urine test for amylase levels, be sure to tell your doctor about all the medicines that you have taken recently. Including hormones and oral contraceptives.

If amylase is lowered, what does it mean?

A low amylase level is considered if less than 100 U / l of serum is found in the results of the analysis. This may be due to various reasons. For example, decreased amylase may result from acute or chronic hepatitis. With this disease, there is a violation of carbohydrate metabolism in the body, because of which all enzymes, and especially amylase, experience increased stress. And although the synthesis of amylase occurs uninterruptedly, much more is consumed. Therefore, a blood test shows an insufficient amount of this enzyme.

The rate of amylase in the blood may decrease as a result of a malignant tumor of the pancreas - tissue degeneration occurs here, and the production of the enzyme is disrupted. This phenomenon is called pancreatic insufficiency. It can also be caused by trauma or if the pancreas has been removed by surgery.

If amylase is lowered, this may be due to severe cystic fibrosis.

Remember that it is impossible to establish an accurate diagnosis based on the results of a single analysis. To clarify and confirm it, the specialist must take into account all the cumulative factors, and, if necessary, appoint an additional examination.