207例急性胰腺炎合并肝功能损害的临床观察  

Acute pancreatitis accompanied with liver function damage: a clinical observation of 207 cases.

作　　者：陈畅[1] 张文俊[2] 刘岩[2] 李兆申[2] 

机构地区：[1]湖北省宜昌市第一人民医院消化内科,宜昌443000 [2]第二军医大学长海医院消化内科

出　　处：《胰腺病学》2006年第5期259-261,共3页Chinese JOurnal of Pancreatology

摘　　要：目的研究急性胰腺炎(AP)合并肝功能损害的临床特点、发病机制及对预后的预测。方法对207例合并肝功能损害AP患者按照病因、严重程度、年龄分组。分别比较各组患者肝功能损害的严重程度、预后及转归,分析对AP严重程度预测灵敏度、特异度较显著的肝功能变化指标。结果重症急性胰腺炎(SAP)肝功能损害的严重程度明显高于轻症急性胰腺炎(MAP)(P<0.05)。胆源性AP肝功能指标中ALT、ALP、LDH比非胆源性AP损害程度重(P<0.05);胆源性AP比非胆源性AP符合SAP人数、转手术率、死亡率均较高,住院天数较长。不同年龄AP患者肝功能损害的严重程度无显著差异(P>0.05)。各肝功能指标中ALT、AST、LDH对AP严重程度预测灵敏度、特异度较显著。结论胆源性AP合并肝功能损害明显。ALT、AST、LDH等肝功能变化指标可作为对AP严重程度预测的参考指标。Objective To investigate the clinical profiles, pathogenesis and prognosis prediction of patients with acute pancreatitis and hver function damage. Methods Two hundred and seven patients of acute pancreatitis and liver function damage were grouped according to etiopathogenisis, severity of disease and. and patients＇ age. The severity of liver function damage, prognosis and turnover of each group were compared; the liver function indices, which are more sensitive and more specific in predicting the severity of acute pancreatitis were analyzed. Results The severity of liver function damages in severe acute pancreatitis （SAP） patients was higher than that in mild acute pancreatitis （MAP） patients（P〈 0.05）. Theliver function indices such as ALT, ALP, LDH in biliary acute pancreatitis （BAP） were worse than those in non-biliary acute pancreatitis （NAP）（P〈 0.05）. Patients with BAP were tended to have severe acute pacreatitis than patients with NAP did; moreover, BAP patients had higher operation rate, higher mortality, and longer hospitalization. There was no difference in severity of liver function damage between patients of different ages groups（P 〉0.05）. ALT. AST, and I.DH had high sensitivity and specificity in predicting acute pancreatitis severity. Conclusions Patients with BAP have obvious liver function damage. AI.T, AST, and LDH might be used in predicting the severity of acute pancreatitis.

关 键 词：胰腺炎 急性病 肝功能损害 

分 类 号：R576[医药卫生—消化系统]