Korean J Med.  2000 Feb;58(2):161-169.

The LDH to AST ratio as an indicator of pancreatic necrosis in acute biliary and alcoholic pancreatitis

• Kim JH
• Kim CU
• Jang HJ
• Bahk WJ
• Park JC
• Kang SS
• Kae SH
• Lee J
• Kim YB
• Joo SA

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.

Keyword

Acute biliary pancreatitis; Acute alcoholic pancreatitis; Pancreatic necrosis; LDH, LDH/AST ratio

MeSH Terms

Alcoholics*
Humans
L-Lactate Dehydrogenase
Necrosis*
Pancreatitis, Alcoholic*
Plasma
Tomography, X-Ray Computed
L-Lactate Dehydrogenase