高脂血症性重症急性胰腺炎临床特点分析

目的回顾性分析高脂血症性重症急性胰腺炎(HLSAP)的临床特点。方法以2011年1月至2015年12月间安徽医科大学第一附属医院和安徽医科大学第二附属医院收治的43例HLSAP作为研究组,以同时期收治的67例非高脂血症性重症急性胰腺炎(NHLSAP)作为对照组,对比分析HLSAP的临床特点;根据入院时甘油三酯(TG)水平,将43例HLSAP分为高TG组和极高TG组,对比分析TG的水平对HLSAP疾病严重程度的影响。结果 HLSAP组对比NHLSAP组的结果:HLSAP组发病年龄以及血清总钙离子、血清总胆红素、血淀粉酶的水平显著低于NHLSAP组;HLSAP组的体重指数、饮食诱因、AP发作史、合并糖尿病、合并脂肪肝、血红细胞压积、血肌酐(Cr)、血糖、超敏C反应蛋白(hs-CRP)、入院24小时内SIRS评分、SOFA评分、并发急性胰周液体积聚比例、并发肾功能衰竭比例、并发多器官功能衰竭(MODS)的比例以及病程中行腹腔穿刺的比例均显著高于NHLSAP组。HLSAP中高TG组对比极高TG组结果:极高TG组的hs-CRP、Cr、血尿素氮水平以及并发肾功能衰竭、MODS的比例、入院24小时内SIRS评分、入院24小时内SOFA评分显著高于高TG组。结论高脂血症性重症急性胰腺炎具有以下特点:发病年龄偏低,体重指数偏高,多有饮食诱因,多合并有糖尿病和脂肪肝,炎症反应更重,更易发生肾衰和MODS,其病情严重程度与甘油三酯水平存在相关性。

Analysis of clinical characteristics of hyperlipidemic severe acute pancreatitis

Objective Toretrospectively analysethe clinical characteristics of hyperlipidemic severe acute pancreatitis.Methods The 43 cases of hyperlipidemic severe acute pancreatitisfrom January 2011 to December 2015 admitted in the First and the Second Affiliated Hospital of Anhui Medical University were as the research group,67 cases of non-hyperlipidemic severe acute pancreatitis admitted at the same time were as the control group,the clinical characteristics were analyzed by comparing this two groups.According to the level of triglyceride,43 cases of hyperlipidemic severe acute pancreatitis were divided into 16 cases of high triglyceride group and 27 cases of extremely high triglyceride group,to analysethe effects of triglyceride level on the severity of hyperlipidemic severe acute pancreatitis.Results The group of hyperlipidemic severe acute pancreatitis in comparison with the group of non-hyperlipidemic severe acute pancreatitis:At the aspects of age of onset,the level of serum Ca2 +,serum total bilirubin and serum amylase,the group of hyperlipidemic severe acute pancreatitiswas significantly lower than the group of non-hyperlipidemic severe acute pancreatitis.At the aspects of the body mass index,food intake,acute pancreatitisattack history,diabetes,fatty liver,SOFA scores in 24 hours after admission,rate of abdominal puncture and the level of blood Hct,total cholesterol,triglyceride,serum creatinine,glucose,high sensitivity C reactive protein,the group of hyperlipidemic severe acute pancreatitiswas significantly higher than the the group of non-hyperlipidemic severe acute pancreatitis.The group of high triglyceride group in comparison with extremely high triglyceride group:At the aspacts of renal failure ratio,the ratio of multiple organ dysfunction syndrome,SOFA scores,the level of high sensitivity C reactive protein,the level of blood urea nitrogen and the level of serum creatinine,the extremelytriglyceride group was significantly higher than that of the group of high triglyceride.Conclusion Hyperlipidemic severe acute pancreatitishas the following characteristics:the age was concentrated in youth,with high body mass index,with more remote cause of diet,with more diabetes and fatty liver,the inflammatory reactionwas more serious,with more likely to occur renal failure and multiple organ failure,there was a correlation between the severity of hyperlipidemic severe acute pancreatitis and the level of triglyceride.