血淀粉酶持续升高时间对急性胰腺炎合并代谢综合征预后的预测价值

目的 探讨血淀粉酶持续时间对急性胰腺炎合并代谢综合征预后的预测价值。方法 选择急性胰腺炎患者150例,其中单纯胰腺炎患者50例,合并代谢综合征患者100例。合并代谢综合征患者中,血淀粉酶恢复正常时间超过5 d患者50例,5 d内恢复正常患者50例。150例急性胰腺炎患者出院后均随访1个月,对是否合并代谢综合征,其血淀粉酶及升高持续天数进行比较,同时统计合并代谢综合征患者,血淀粉酶恢复时间与血脂血糖水平变化情况以及发生并发症情况。结果 合并代谢综合征患者血淀粉酶水平高于未合并代谢综合征患者(P<0.05),且血淀粉酶升高持续天数长于未合并代谢综合征患者(P<0.05)。血淀粉酶恢复时间超过5 d患者的总胆固醇、甘油三酯、空腹及餐后2 h血糖水平均高于5 d内恢复正常患者(P<0.05)。血淀粉酶恢复时间超过5 d患者,发生低蛋白血症、血糖异常、低钾血症、低钙血症及低镁血症的比例显著高于5 d内恢复正常患者(P<0.05)。结论 急性胰腺炎合并代谢综合征患者的血淀粉酶持续升高时间越长,其越容易发生血脂、血糖代谢异常,治疗中应注意调节患者电解质。

The prognostic value of serum amylase duration in acute pancreatitis with metabolic syndrome

Objective To evaluate the prognostic value of serum amylase duration in acute pancreatitis with metabolic syndrome. Methods A total of 150 cases with acute pancreatitis were chosen, including 50 cases with pancreatitis amylase returned to normal time, 50 cases whose recover time was over 5 days, and 50 cases were returned in 5 days; after discharge, all were followed one month, and whether with metabolic syndrome and blood amylase increases were compared for several days; meanwhile, serum amylase recovery time and blood lipid changes in blood glucose levels and the occurrence of complications in patients with metabolic syndrome were statistically analysed. Results With metabolic syndrome, serum amylase levels were higher than patients without metabolic syndrome(P<0.05), and the duration of increased serum amylase was longer than those without metabolic syndrome(P<0.05). For patients whose serum amylase enzyme recovery time was more than 5 days, their total cholesterol, triglycerides, fasting glucose and 2-hour postprandial blood glucose levels were higher than those whose serum amylase returned to normal within 5 days(P<0.05). For patients whose serum amylase recovery time was more than 5 days, the incidence of low albumin, glucose, the proportion of hypokalemia, hypocalcemia and hypomagnesemia was significantly higher than those whose serum amylase was normal in 5 days(P<0.05). Conclusion In acute pancreatitis with metabolic syndrome, the more the duration of serum amylase rise, the more prone to blood lipid and glucose metabolism, so the electrolyte balance adjustment should be highlighted in the treatment.