急性胰腺炎合并高脂血症的临床特点

目的 探讨急性胰腺炎(AP)合并高脂血症患者的病因及临床特点.方法 收集2002年1月至2007年12月收治的AP患者497例,纳入符合标准的60例.以三酰甘油(TG)>11.3 mmol/L或者TG在5.65～11.3 mmol/L之间,但血清呈乳状者为标准分为重度高脂血症组和轻度高脂血症组,另按病情严重程度分为轻症急性胰腺炎组(MAP)和重症急性胰腺炎组(SAP),分别观察其病因及临床特点.结果 重度高脂血症组13例,轻度高脂血症组47例.重度组5例(38.5%)有AP发作史,显著高于轻度组的10.6%(P<0.05);重度组病因以高脂血症为主,轻度组以胆源性为主.重度组血清总胆固醇(TC)为(8.17±2.76)mmol/L,TG为(13.47±4.12)mmol/L,显著高于轻度组的(4.97±1.67)mmol/L和(4.09±2.18)mmol/L(P<0.01).另一方面,SAP组血淀粉酶、血糖、TG、TC及腹痛缓解时间分别为(1396±2233)U/L、(14.17±8.37)mmol/L、(7.69 ±6.56)mmol/L、(5.39±3.58)mmol/L和(6.30±3.27)d,MAP组分别为(831±1348)U/L、(8.28±3.89)mmol/L、(5.55±3.92)mmol/L、(5.64±1.79)mmol/L和(4.29±2.62)d,两组比较,仅血糖水平和腹痛缓解时间具有显著差异(P<0.05).结论 重度高脂血症者AP的复发率高,高血脂程度与AP的发生关系密切,但与病情严重程度无关.

Clinical characteristics of acute pancreatitis complicated with hyperlipidemia

Objective To investigate the etiology and clinical characteristics of acute pancreatitis complicated with hyperlipidemia.Methods 497 patients admitted from Jan.2002 to Dec.2007 were screened,60 patients who fulfiHed the inclusion criteria were enrolled,and these patients were divided into two groups according to the level of serum triglyeeride and disease severity respectively.Patients whose serum level of triglyeeride>11.3 mmoVL were defined as severe hyperlipidemia group.while those patients whose serum level of triglyceride between 5.65～11.3 mmol/L with milky serliiH were defined as mild hyperlipidemia group.Patients were classified into mild acute pancreatitis(MAP) and Severe acute pancreatitis(SAP) groups according to the disease severity.The etiology and clinical characteristics in all patients were investigated. Results There were 13 patients in severe hyperlipidemia group,47 patients in mild hyperlipidemia group.5 patients(38.5%)in Severe hyperlipidemia group had history of acute pancreatitis,which wag significantly higher than that of mild hyperlipidemia group(10.6%,P<0.05).The etiology was mainly biliary diseases in the mild hyperlipidemia group,and mainly hyperlipidemia in the severe hyperlipidemia group.The levels of total cholesterol and triglyceride was(8.17±2.76)mmol/L and(13.47±4.12)mmol/L,which were significantly higher than(4.97±1.67)mmol/L and(4.09±2.18)mmol/L of mild hyperlipidemia group(P< 0.01).The Serum amylase,gluc08e,TG,Tc and duration of relief of abdominal pain were(1396±2233) U/L.(14.17±8.37)mmol/L,(7.69±6.56)mol/L,(5.39±3.58)mmol/L and(6.30±3.27)d, respectively,in SAP group;and the corresponding values were(831±1348)U/L,(8.28±3.89)mmol/L, (5.55±3.92)moVL,(5.64±1.79)mol/L and(4.29±2.62)d in MAP group;only the values ofglucose and duration of relief of abdominal pain were statistically different(P<0.05).Conclusions The recurrence rate of acute panereatitis was hisher in patients with severe hyperlipdemia;the severity of hyperlipdemia Was closely associated with the development of acute pancreatitis,but not the severity of acute pancreatitis.