高脂血症性急性胰腺炎与胆源性胰腺炎的临床对比分析

目的对比分析高脂血症性急性胰腺炎（hyperlipidemic acute pancreatitis,HLAP）与急性胆源性胰腺炎（acute biliary pancreatitis,ABP）的临床特点。方法回顾性对比分析我院2005年8月～2010年8月间收治的28例HLAP和64例ABP患者的临床资料。结果 HLAP组BMI、重症患者比例、Ranson评分≥3、CT分级为D、E及APACHEII≥8分者均较ABP组高（P〈0.05）。HLAP组血清TG、GLU、UA均显著高于ABP组,而ALT、AKP、TBIL、DBIL及血AMY均显著低于ABP组（P〈0.05）。两组患者平均住院时间无统计学差异（P〉0.05）。HLAP组患者死亡率为14.3%）,显著高于ABP组的1.5%（P〈0.05）。结论与ABP组相比,HLAP组通常病情较重,多为SAP且常不伴有血淀粉酶的显著升高,且死亡率高。

A clinical comparison between hyperlipidemic acute pancreatitis and acute biliary pancreatitis

Objective To compare the clinical features of patients with hyperlipidemic pancreatitis(HLAP) and patients with acute biliary pancreatitis(ABP).Methods The clinical data of 28 patients with HLAP and 64 patients with ABP (August 2005-August 2010) were compared respectively.Results Body mass index (BMI),the ratio of severe cases,the proportion of Ranson score (≥3),the ratio of D and E for Balthazar CT grading and APACHE II score (≥8) were higher in patients with HLAP than that in patients with ABP (P < 0.05).Serum level of TG,GLU and UA were significantly increased in patients with HLAP than that in patients with ABP (P < 0.05),and serum level of ALT,AKP,TBIL and AMY were significantly decreased in patients with HLAP than that in patients with ABP (P < 0.05).No difference was found in mean hospital stay period between the two groups (P > 0.05).The mortality rate was significantly higher in patients with HLAP (14.3%) than that in patients with ABP (1.5%) (P < 0.05).Conclusions Compared with patients in ABP group,the patients in HLAP group were more severe (without significant increase in serum amylase level),and had a higher mortality rate.