高脂血症性重症急性胰腺炎临床特征分析  

Clinical analysis of hyperlipidemic sever acute pancreatitis.

作　　者：沈洪亮[1] 张建表[1] 刘震[1] 

机构地区：[1]上海市浦东新区人民医院消化内科,201200

出　　处：《中国综合临床》2009年第7期741-743,共3页Clinical Medicine of China

摘　　要：目的探讨重症急性胰腺炎（SAP）伴有高TG患者的临床特点。方法收集发病后72h内入院的SAP患者82例，按入院时血清TG水平分为高TG组（≥1．7mmol／L）26例，正常TG组（〈1．7mmol／L）56例。结果高TG者占同期SAP患者的31．71％（26／82）。高TG组患者入院时的APACHE-Ⅱ评分高于正常TG组（14．62±7．58比10．68±5．21，P〈0．01）。高TG组在发病72h内的心、肺和肾脏功能不全的发生率高于正常TG组（34．62％、34．62％、19．23％比5．36％、3．57％、1．79％，P均〈0．01），假性囊肿的发生率亦增高（42．31％比7．14％，P〈0．01）。高TG组无急症或早期手术治疗病例，正常TG组为13例（23．21％）；高TG组和正常TG组分别有2例和4例中转手术。结论高TG的SAP患者早期脏器功能不全发生率和局部并发症高，治疗应以非手术为主。Objective To investigate the clinical characteristics of sever acute pancreatitis （SAP） with high triglyceride（TG） . Methods 82 patients with onset of SAP within 72 hours were involved in this study. These patients were divided into high TG group （ n = 26） and normal TG group （ n = 56） according to serum TG levels tested （ high TG group ≥ 1.7 mmol/L; normal TG group 〈 1.7 mmol/L on admission）. Results 31.71% （26/82） SAP patients were discovered with high TG APACHE- 11 grade of high TG group was higher than that of normal TG group on admission [ （ 14. 62 ± 7.58） vs （ 10. 68 ± 5.21 ）, P 〈 0. 0l ]. Within the onset of 72 hours, the incidence of cardiac, pulmonary and kidney dysfunction in high TG group was higher than those of normal TG group （34.62% ,34.62% and 19.23% vs 5.36% , 3.57% and 1. 790 , P 〈 0.01 ）, and the incidence of pancreatic pseudocysts was higher in high TG group than that of normal group（42.31% vs 7.14% ,P 〈0.01 ）. No emergency and early-stage surgical cases in high TG group but 13 cases（23.21% ） in normal group. There were 2 eases of high TG group and 4 of normal group averting to operation. Conclusion SAP patients with high TG have high incidence of early-stage organ dysfunction and local complication, in this case nonsurgical intervention is the first choice.

关 键 词：重症急性胰腺炎 甘油三酯 多脏器功能不全 并发症 

分 类 号：R576[医药卫生—消化系统]