高脂血症性重症急性胰腺炎降脂治疗与病情转归的关系  

Relationship between Lipid-lowering Therapy on Acute Severe Hyperlipidemic Pancreatitis and Disease Outcome

作　　者：杨宇龙[1] 王农荣[1] 

机构地区：[1]南昌大学第四附属医院消化内科,南昌330003

出　　处：《南昌大学学报（医学版）》2012年第1期56-58,共3页Journal of Nanchang University：Medical Sciences

摘　　要：目的通过对高脂血症性重症急性胰腺炎(hyperlipidemic-severe acute pancreatitis,HL-SAP)的常规治疗与加用降血脂治疗的对照分析,评价降脂治疗在HL-SAP治疗中的作用。方法将61例HL-SAP患者按不同的治疗方法分为2组:研究组33例和对照组28例。对照组患者采用禁食、持续胃肠减压,常规抑酸、抗炎、抑制胰酶分泌,复方丹参注射液、生大黄泡水及对症支持治疗。研究组在对照组治疗的基础上加用低分子肝素钙注射液及胰岛素注射液降血脂治疗。观察2组患者三酰甘油(TG)下降至5.65mmol.L-1、血淀粉酶和C反应蛋白(CRP)恢复至正常及腹痛消失、腹水消退时间等情况。结果 TG下降至5.65mmol.L-1时间:对照组为(5.6±1.6)d,研究组为(3.4±1.1)d,2组比较差异有统计学意义(P<0.01);血淀粉酶恢复至正常时间:对照组为(3.7±1.2)d,研究组为(2.1±0.9)d,2组比较差异有统计学意义(P<0.05);CRP恢复至正常时间:对照组为(8.1±3.2)d,研究组为(6.8±2.5)d,2组比较差异有统计学意义(P<0.05);腹痛缓解时间:对照组为(5.8±2.2)d,研究组为(4.1±1.8)d,2组比较差异有统计学意义(P<0.05);腹水消退时间对照组为(11±2.8)d,研究组为(6.7±2.5)d,2组比较差异有统计学意义(P<0.01)。结论 HL-SAP的TG水平的恢复对临床症状、体征的缓解和缩短病程具有相关性,应用低分子肝素钙注射液及胰岛素注射液对HL-SAP的降血脂治疗是必要的,且安全、有效。Objective To evaluate the effectiveness of lipid-lowering treatment in hyperlipidemic-severe acute pancreatitis（HL-SAP） through comparison with conventional treatment.Methods Sixty-one patients with HL-SAP were divided into two groups according to different treatment strategies.The control group（n=28） was conventionally treated with fasting,continuous gastrointestinal decompression,conventional acid suppression,anti-inflammatory,inhibition of pancreatin secretion,compound Danshen injection,rhubarb infused decocotion and expectant supportive therapy.The study group（n=33） was given low-molecular-weight heparin calcium injection and insulin injection based on conventional treatment.The time courses of decrease in triacylglycerol（TG） concentrations to 5.65 mmol·L-1,return of serum amylase and C-reactive protein（CRP） levels to normal,abdominal pain deprivation and ascites subsidence were observed in both groups.Results Time courses of decrease in triacylglycerol（TG） concentrations to 5.65 mmol·L-1,return of serum amylase levels to normal,return of C-reactive protein（CRP） levels to normal,abdominal pain deprivation and ascites subsidence were,respectively,（5.6±1.6）,（3.7±1.2）,（8.1±3.2）,（5.8±2.2） and（11±2.8） days in control group,and（3.4±1.1）,（2.1±0.9）,（6.8±2.5）,（4.1± 1.8） and（6.7 ±2.5） days in study group,and differences were significant between the two groups（P0.05 or P0.01）.Conclusion The recovery of TG levels is correlated with clinical symptoms,sign remission and course decurtation in patients with HL-SAP.Low-molecular-weight heparin calcium injection and insulin injection are necessary,safe and effective in lipid-lowering therapy on HL-SAP.

关 键 词：高脂血症性重症急性胰腺炎 三酰甘油 低分子肝素钙注射液 胰岛素注射液 病情 转归 

分 类 号：R657.51[医药卫生—外科学]