急性胰腺炎合并肝功能损害的临床观察

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:2003年至2006年伴有急性肝功能损害的急性胰腺炎病人137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48.9%,其中胆源性胰腺炎占66.4%.急性肝功能损害主要表现为血清谷丙转氨酶或谷草转氨酶升高(46.3%),或同时伴有血清胆红素升高(42.6%).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＜0.05),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＞0.05).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.

Clinical Observation of Acute Liver Damage in Patients with Acute Pancreatisis

Objective:To investigate the causes for and prognosis of acute liver damage in patients with acute pancreatitis.Method: A total of 137pancreatitis patient with acute liver damage treated in our hospital from 2003 to 2006 were included in this study.The etiology of acute pancreatitis and results of laboratory test for liver function were analyzed.Result: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 billiary pancreatitis accounted for 66.44%.High levels of serum glutamicpyruvicor serum glutamic oxalacetic transaminase(46 3%),or elevated serum bilirbin(42.6%)were the main types of acute liver damage.Higher levels of serum or urineamylase,White blood cell count and glucose were significantly correlated to acute liver damage(P<0 05).However,these verity degree of acute pancreatisis,renal function damage,respiratory insufficiency and the formation of pancreatic pseudo cyst were not significantly correlated to the damage(P>0 05).Conclusion: Acute liver damage is a common extra pancreatic organ functional disorder in patients with acute pancreatitis.It might be developed as a result of systemic body inflammatory reaction has no definite relation to prognosis of acute pancreatitis.