重症急性胰腺炎患者发生多器官功能障碍综合征的危险因素  

Risk factors of the onset of multiple organ dysfunction syndrome in patients with severe acute pancreatitis

作　　者：王心[1] 崔云峰[1] 苗彬[1] 张大鹏[1] 赵二鹏[1] 李忠廉[1] 崔乃强[1] 

机构地区：[1]天津市南开医院外二科,300100

出　　处：《中华消化外科杂志》2009年第4期272-274,共3页Chinese Journal of Digestive Surgery

摘　　要：目的探讨早期（入院后24h内）评估重症急性胰腺炎（SAP）患者的相关指标，预测SAP患者发生MODS的危险因素。方法回顾性分析1998年1月至2008年9月天津南开医院收治的338例SAP患者临床资料。按照患者是否发生MODS分为MODS组（163例）和对照组（175例），检测两组患者的各种指标，采用t检验和Logistic回归法分析SAP患者发生MODS的危险因素。结果WBC≥16×10^9／L、血肌酐≥180μmol／L、血钙≥2．5mmol／L、C反应蛋白≥120mg／L、血pH值≥7．35为最易导致MODS的危险因素（χ^2=51．720，21．421，12．393，P〈0．05）。TC在3．67～5．23mmol／L范围内为保护性因素。结论感染、肾功能不全、高钙血症可早期预测SAP患者住院期间发生MODS，其中尤以感染最重要，TC适量升高可以减少MODS的发生。Objective To analyze the value of early evaluation in predicting the onset of multiple organ dysfunction syndrome （MODS） in patients with severe acute pancreatitis （SAP）. Methods The clinical data of 338 patients with SAP who had been admitted to Tianjin Nankai Hospital from January 1998 to September 2008 were retrospectively analyzed. The patients were divided into MODS group （n = 163 ） and control group （n = 175 ） according to whether they did or did not have MODS. Risk factors causing MODS were analyzed by t test and Logistic regression analysis. Results The factors leading to the MODS included white blood cells count ≥ 16 × 10^9/L, serum creatinine≥ 180 μmol/L, serum calcium ≥2.5 mmol/L, c-reactive protein ≥ 120 mg/L and pH value of blood≥7.35 （χ^2 = 51. 720, 21. 421, 12. 393, P 〈 0.05）. The total cholesterol was a protective factor when it was 3.67-5.23 mmol/L. Conclusions Infection, renal insufficiency and hypercalcinemia are early predictive factors for MODS, and infection is the strongest predictive factor. Appropriate elevated total cholesterol can reduce the incidence of MODS.

关 键 词：重症急性胰腺炎 多器官功能障碍综合征 危险因素 

分 类 号：R576[医药卫生—消化系统] R459.7[医药卫生—内科学]