重症高甘油三酯性急性胰腺炎的临床特征分析

唐永凤; 唐国都; 梁志海; 覃蒙斌; 黄华丽; 覃敏珍

doi:10.3969/j.issn.1001-5256.2019.04.024

重症高甘油三酯性急性胰腺炎的临床特征分析

DOI: 10.3969/j.issn.1001-5256.2019.04.024

广西医科大学第一附属医院消化内科

基金项目:

国家自然科学基金项目(8156040100)；

详细信息

中图分类号: R576
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出版历程
- 收稿日期: 2018-10-31
- 出版日期: 2019-04-20

Clinical features of severe acute hypertriglyceridemic pancreatitis

Department of Gastroenterology, The First Affiliated Hospital of Guangxi Medical University

Research funding:

摘要

摘要: 目的分析重症急性高甘油三酯性急性胰腺炎（HTGP）的临床特点。方法收集2013年1月-2016年6月广西医科大学第一附属医院179例中度重症急性胰腺炎（MSAP）和重症急性胰腺炎（SAP）患者资料。按病因分为4组:重症胆源性急性胰腺炎68例、重症酒精性急性胰腺炎39例、HTGP 45例及其他重症急性胰腺炎组（其他组） 27例,记录前3组有明确病因患者的人口学资料、入院第1天TG水平、病因、胰腺坏死,全身并发症[急性呼吸窘迫综合征（ARDS）、急性肾功能损伤、低血压、弥散性血管内凝血],其他临床结果（是否入住ICU、住院时间、病死率）。为了进一步了解TG浓度对AP患者转归的影响,根据入院第1天TG水平不同分为血脂正常（82例）、轻度（52例）、中度（28例）、重度（17例） 4组,对不同水平组全身并发症、胰腺坏死、临床结果的发生率进行分析。计量资料多组间比较采用Kruskal-Wallis H检验,计数资料组间比较采用χ2检验,采用Spearman秩相关作相关分析。结果结果显示,胆道疾病仍然是SAP的第一大病因（38%）,而高甘油三酯血症成为了SAP的第二大病因（25%）。全身并发症的比...
- 胰腺炎,急性坏死性 /
- 高甘油三酯血症 /
- 体征和症状
Abstract: Objective To investigate the clinical features of severe acute hypertriglyceridemic pancreatitis ( HTGP) . Methods A retrospective analysis was performed for the clinical data of 179 patients with moderate severe pancreatitis ( MSAP) or severe acute pancreatitis ( SAP) who were admitted to The First Affiliated Hospital of Guangxi Medical University from January 2013 to June 2016. According to the etiology, these patients were divided into severe biliogenic acute pancreatitis ( biliogenic AP) group with 68 patients, severe alcoholic acute pancreatitis ( alcoholic AP) group with 39 patients, severe acute HTGP group with 45 patients, and severe acute pancreatitis group with other causes ( other group) with 27 patients. Related data of the patients with clear causes in the former three groups were recorded, including demographic data, blood triglyceride ( TG) level on the first day of admission, cause, pancreatic necrosis, systemic complications [acute respiratory distress syndrome ( ARDS) , acute renal injury, hypotension, and disseminated intravascular coagulation ( DIC) ], and related clinical outcomes ( admission to the intensive care unit, length of hospital stay, and mortality rate) . In order to investigate the influence of TG concentration on the prognosis of AP patients, the patients were divided into normal blood lipid group with 82 patients, mild dyslipidemia group with 52 patients, moderate dyslipidemia group with 28 patients, and severe dyslipidemia group with 17 patients, according to the TG level on the first day of admission, and the incidence rates of systemic complications, pancreatic necrosis, and clinical outcomes were analyzed. The Kruskal-Wallis H test was used for comparison of continuous data between multiple groups, the chi-square test was used for comparison of categorical data between groups, and the Spearman rank correlation test was used for correlation analysis. Results Biliary tract disease remained the leading cause of SAP ( 38%) , followed by hypertriglyceridemia ( 25%) . As for systemic complications, the HTGP group had a significantly higher incidence rate of ARDS than the biliogenic AP group and the alcoholic AP group ( P = 0. 014 and0. 022) . In the groups with different TG levels, the incidence rates of ARDS and acute renal injury were positively correlated with TG level ( r = 0. 966 and 0. 982, P = 0. 004 and 0. 019) . Conclusion The HTGP group has a higher incidence rate of ARDS than the biliogenic AP group and the alcoholic AP group, and the risk of ARDS and acute renal injury tends to increase with the increasing TG level.
- pancreatitis, acute necrotizing /
- hypertriglyceridemia /
- signs and symptoms

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