高脂血症性胰腺炎与急性胆源性胰腺炎的特征比较

目的:比较高脂血症性胰腺炎（HLAP）和急性胆源性胰腺炎（ABP）的临床特点，提高对HLAP的诊疗水平。方法:依据病因将88例胰腺炎患者分为HLAP组（28例）和ABP组（60例），比较2组患者一般临床资料、主要生化指标、影像学资料、伴随疾病、病死率、复发率等方面资料。结果:HLAP合并脂肪肝、糖尿病和APACHEⅡ评分、重症胰腺炎均高于ABP（P<0.05～P<0.01），而病死率、HLAP患者总胆固醇、TG、血糖、C反应蛋白均高于ABP组，而淀粉酶、丙氨酸氨基转移酶和胆红素均低于ABP组（P<0.01）。2组患者入院后48 h病死率、Ranson评分、胰腺假性囊肿形成如胸腔积液和复发率差异均无统计学意义（P>0.05）。而APACHEⅡ评分和重症胰腺炎发生率均高于ABP组（P<0.05）。结论:HLAP临床特点独特，其临床表现不典型，合并基础疾病多，易复发，除常规治疗外，尽快降低血脂水平是治疗关键。

Characteristic comparison of the hyperlipidemic pancreatitis with acute biliary pancreatitis

Objective:To compare the clinical characteristics of hyperlipidemic acute pancreatitis ( HLAP ) and acute biliary pancreatitis( ABP) ,and improve the diagnosis and treatment of HLAP. Methods:Eighty-eight patients with pancreatitis were divided into the HLAP group(28 cases) and ABP group(60 cases) according to the pathogeny. The general clinical data,main biochemical index, imaging data, accompanying disease, mortality and recurrence rate between two groups were compared. Results: The hyperlipidemia pancreatitis complicated with fatty liver,diabetes mellitus,severe pancreatitis and recurrence rate in HLAP group were more than those in ABP group(P<0. 05-P<0. 01),but the APACHEⅡ and the incidence of severe acute pancreatitis were higher than in ABP group. Conclusions:The HLAP patient has unique clinical characteristics, and its clinical manifestation is not typical, which complicated with foundation disease is more and easy to recur. In addition to the conventional treatment,quick reducing the blood lipid level is the key of treatment as soon as possible.