急性胰腺炎伴肝损伤的临床分析  

Clinical analysis of acute pancreatitis associated with liver injury

作　　者：周琳[1] 欧阳资武[1] 付祖姣[1] 周江[1] 李敏[1] 李子博[1] 

机构地区：[1]长沙医学院医学检验系临床生物化学教研室,湖南长沙410219

出　　处：《国际检验医学杂志》2013年第4期412-414,共3页International Journal of Laboratory Medicine

摘　　要：目的探讨急性胰腺炎(AP)严重程度与肝功能受损指标的相关性,分析AP时肝损伤的发生概率与AP严重程度之间的关系,并探讨不同严重程度的AP患者之间年龄、性别、体重指数是否存在差异。方法通过收集2011年10月至2012年6月长沙医学院附属医院检验科的AP患者72例的临床资料,其中轻度26例、中度31例、重度15例;水肿型52例,坏死型20例。并随机选取25例健康成年人作为对照组。比较轻、中、重度3组与对照组之间年龄、性别、体质量指数的差异和肝功能受损指标ALT或AST的关系以及水肿型、坏死型AP与ALT或AST的关系并进行统计学分析。结果对照组、轻型组、中型组和重型组之间年龄和性别比较差异无统计学意义(P>0.05),但轻型、中型、重型3组体质量指数与对照组相比差异有统计学意义(P<0.05)。轻、中、重度3组病例ALT或AST阳性率与健康对照组比较差异均有统计学意义(P<0.05),而在轻、中、重度3组病例ALT或AST阳性率的两两比较中,轻度、中度和重度之间比较差异均有统计学意义(P=0.003,P=0.005),而中度与轻度之间差异无统计学意义(P>0.05)。水肿型与坏死型两组ALT或AST阳性率均高于健康对照组,差异有统计学意义(P<0.05),且水肿型与坏死型两组之间ALT或AST阳性率比较,差异有统计学意义(P=0.0001)。结论肥胖是AP的诱发因素;AP严重程度与胰腺炎伴有肝损害有一定相关性,其损害程度可反映AP严重程度;急性坏死型胰腺炎的肝损害发生率要高于水肿型胰腺炎。Objective To study the correlation between the acute pancreatitis（AP） serious degree and indexes of liver function damage,and analyze the relationship between the probability of AP liver damage and AP severity and discusses the the difference of age,sex and weight index of patients with different severity of AP. Methods Clinical laboratory data of 72 patients with AP in Changsha Medical College Affiliated Hospital through October 2011 to June 2012,including 26 cases with mild pancreatitis, 31 cases with moderate pancreatitis and 15 cases with severe pancreatitis,and 52 cases of oedema type and 20 cases of necrosis type. 25 cases of healthy adults were randomly selected as control group. The age, sex, and weight index were compared between the different groups,and the relationship between the liver function and damaged index ALT or AST was analyzed. Meanwhile, the relationship between oedema or necrosis type AP and ALT or AST were also analyzed. Results There was no significant difference between the control group,mild group,the moderate group and severe group of age and sex（P〉0.05）, but weight index of these groups were different with control group（P〈0.05）. Positive rate of mild,moderate and severe group were different with control group（P〈0. 05 ）, and there were statistical difference between mild and severe group and between moderate and severe group（P〈0.05）. Positive rate of ALT or AST in oedema and necrosis type groups were higher than control group（P〈0.05） and those of the two patient groups were also statistically different（P〈0.05）. Conclusion Obesity could be a causative factor of AP. There might be certain correlation between the severity of AP and the damage of liver function. The incidence rate of liver injury in necrosis type of AP could be higher than oedema type of AP.

关 键 词：胰腺炎 肝 转氨酶类 

分 类 号：R576[医药卫生—消化系统]