急性胰腺炎病人急性肝功能损害

目的　探讨急性胰腺炎病人急性肝功能损害的发生原因和预后。方法　 1997～ 2 0 0 0年伴有急性肝功能损害的急性胰腺炎病人 14 9例 ,按急性胰腺炎病因学及肝功能检查结果进行分类 ,与同期不伴有急性肝功能损害的急性胰腺炎病人进行对比 ,以发生急性胰腺炎并发症分析其预后。结果　伴有急性肝功能损害的急性胰腺炎占同期急性胰腺炎病人总数的 5 3 0 3% ,其中胆源性胰腺炎占 6 6 4 4 %。急性肝功能损害主要表现为血清谷 丙或谷 草转氨酶升高 (4 6 31% ) ,或同时伴有血清胆红素升高 (4 2 5 9% )。入院时病人的血、尿淀粉酶明显升高、血白细胞计数以及血糖增高与急性胰腺炎急性肝功能受损有关 (P <0 0 5 ) ,但急性胰腺炎的严重程度、以及肾功能受损、呼吸功能不全、胰腺假性囊肿的形成等与肝功能损害无关 (P >0 0 5 )。结论　急性胰腺炎病人急性肝功能损害是急性胰腺炎常见的胰腺外器官功能障碍 ,其发生可能是由于急性胰腺炎全身炎症反应的一种结果 ,与急性胰腺炎的预后无明显关系。

Acute liver damage in patients with acute pancreatitis

Objective To investigate the causes for and prognosis of acute liver damage in patients with acute pancreatitis. Methods A total of 149 acute pancreatitis patients with acute liver damage treated in our hospital from 1997 to 2000 were included in this study. The etiology of acute pancreatitis and results of laboratory tests for liver function were analyzed. Results The patients with acute liver damage accounted for 53.03% of all the patients in the same period of time. For which,the patients with biliary pancreatitis accounted for 66.44%. High levels of serum glutamic-pyruvic or serum glutamic-oxalacetic transaminase (46.31%),or elevated serum bilirubin (42.59%) were the main types of acute liver damage. Higher levels of serum or urine amylase,white blood cell count and glucose were significantly correlated to acute liver damage (P<0.05). However,the severity degree of acute pancreatitis,renal function damage,respiratory insufficiency and the formation of pancreatic pseudocyst were not significantly correlated to the damage (P>0.05). Conclusions Acute liver damage is a common extrapancreatic organ functional disorder in patients with acute pancreatitis. It might be developed as a result of systemic body inflammatory reaction and has no definite relation to prognosis of acute pancreatitis.