高脂血症性急性胰腺炎36例临床分析

目的 探讨高脂血症性急性胰腺炎的临床特点和发病机制,加强对该病的认识.方法 回顾性分析36例高脂血症性急性胰腺炎(hyperlipidemic acute pancreatitis,HLAP)和同期40例急性胆源性胰腺炎(acute biliary pancreatitis,ABP)患者的临床资料,对其临床特点、实验室指标、治疗方法进行总结.结果 HLAP组中血淀粉酶正常者2例,尿淀粉酶正常者5例,其余患者血尿淀粉酶均不同程度升高；血脂明显高于ABP组(P＜0.05)；其并发症及复发率均高于ABP组(P＜0.05).结论 对于高度怀疑胰腺炎者,在入院后开始治疗前应常规查血脂、血尿淀粉酶、腹部CT或彩超,结合临床症状可帮助诊断.除常规治疗外,尽快将血脂降至安全水平是治疗的关键.

Clinical analysis of hyperlipidemic acute pancreatitis in 36 cases

Objective To elucidate the clinical features and pathogenesis of hyperlipidemic pancreatitis to strengthen the understanding of this disease.Methods The clinical data in 36 cases of hyperlipidemic acute pancreatitis(HLAP) and 40 cases of acute biliary pancreatitis(ABP) were retrospectively analyzed on the clinical characteristics,laboratory indexes and the treatment.Results There were 2 cases of normal blood amylase,5 cases of normal urine amylase in the HLAP group and the blood amylase and urrne amylase in the other potients all showed high level in different degrees.Compared with the ABP group,serum level of triglyceride,complications and recurrence rate in the HLAP group were higher(P<0.05),while amylase level was lower(P<0.05).Conclusion In highly suspected pancreatitis,the inpatient should be checked blood lipids,blood and urine amylase,abdominal CT or color Doppler ultrasound before treatment after admission,which combined with clinical symptoms may be conducive to the diagnosis.In addition to conventional therapeutic measures,reducing blood lipids to a safe level as quickly as possible is the key of treatment.