急性胰腺炎伴高三酰甘油血症的临床特点  

Clinical characteristics of acute pancreatitis complicated with hypertriglyceridemia

作　　者：陈嘉屿[1] 张方信[1] 吴红梅 马强[1] 吴汉平[1] 汪泳[1] 康生朝[1] 

机构地区：[1]兰州军区兰州总医院,甘肃兰州730050 [2]甘肃省中医学校

出　　处：《西北国防医学杂志》2008年第3期186-188,共3页Medical Journal of National Defending Forces in Northwest China

基　　金：甘肃省自然科学基金资助项目(2007GS04532)

摘　　要：目的：探讨高三酰甘油血症对急性胰腺炎（AP）临床表现及其脏器功能的影响。方法：2004—04—2006—12我院共收治491例AP，按三酰甘油水平高低分为血脂正常组、血脂增高组、高脂血症性胰腺炎（HLP）组，分析其临床特点、并发症、平均住院日、病死率等。结果：血淀粉酶、血钙随三酰甘油水平增高而下降（P〈0．05或P〈0．01）；而血糖、CHP、APACHEⅡ评分明显升高（P〈0．05）；平均住院日延长（P〈0．05）；胸腹腔积液发生率增高（P〈0．05和P〈0．01）；当三酰甘油〉5．65mmol／L时，急性肺损伤、急性肾衰竭、休克发生率明显增加（P〈0．05），并且病死率增加（P〈0．05）；肠麻痹或肠梗阻发生率在三酰甘油增高时显示增加趋势，但差异无显著性（P〉0．05）。结论：临床诊断中应注意三酰甘油水平增高时，常不伴血淀粉酶的显著升高。诊治早期应警惕重症化倾向。高三酰甘油血症可增加并发症发生率及病死率。Objective：To investigate the effect of hypertriglyceridemia on the clinical characteristics and organic functions in acute pancreatitis （AP） patients. Methods： A total of 491 patients with AP between Apr 2004 and Dec 2006 were divided into normal lipidemia, hoisting lipidemia and hyperlipidemic pancreatitis group according to the level of triglyceride. The clinical characteristics, complications, hospitalized time and mortality were analyzed. Results： Compared with patients with lower triglyceride level, the patients with higher triglyceride level had significantly lower serum amylase and calcium levels （ P 〈0.05 or P 〈0.01 ）, had markedly higher serum glucose, C - reaction protein （CRP） levels and APACHE Ⅱ score （ P 〈 0.05 ）, with prolonged hospitalized time （ P 〈 0.05 ） and higher incidence of the pleural effussion and seroperitoneum （ P 〈 0.05 and P 〈 0.01 ）. When triglyceride level exceeded 5.65 mmol/L, the incidences of acute lung injury, renal failure, shock and mortality were markedly increased （ P 〈 0, 05 ）. The incidences of enteroparalysis and intestinal obstruction showed the trend of increase along with the serum triglyceride level, but there was no significant differences statistically （P 〉 0.05 ）. Conclusion： The serum amylase level may have no significant change in AP patients with higher triglyceride level, which should be concerned in the early diagnosis and treatment. The hypertriglyceridemia may increase the complication and mortality.

关 键 词：急性胰腺炎 高三酰甘油血症 临床特点 并发症 

分 类 号：R576[医药卫生—消化系统]