高脂血症性急性胰腺炎和胆源性急性胰腺炎临床特征分析  

Comparitive study on clinical features between hyperlipidemic acute pancreatitis and biliary acute pancreatitis

作　　者：刘圆圆[1] 江迈红[1] 戴光荣[1] 

机构地区：[1]延安大学附属医院消化内科,延安716000

出　　处：《山西医科大学学报》2013年第12期976-979,共4页Journal of Shanxi Medical University

摘　　要：目的对比分析高脂血症性急性胰腺炎(hyperlipidemic acute pancreatitis,HLAP)和胆源性急性胰腺炎(acute biliary pancreatitis,ABP)的临床特征。方法回顾性分析我院27例HLAP和61例ABP患者的临床表现、实验室指标、并发症、预后等。结果 HLAP多见于中年男性患者,体重指数(body mass index,BMI)偏高,常伴有脂肪肝、糖尿病。HLAP组ALT、AST、TBIL、DBIL、血Ca2+、血尿淀粉酶及手术率低于ABP组;HLAP组TG、TC、GLU及复发率高于ABP组(P<0.05)。两组患者的临床严重程度分型、三种评分(Ranson评分、APACHE-Ⅱ评分、胰腺BalthazarCT评分)、白细胞计数、并发症、住院天数及病死率比较无差异(P>0.05)。结论与ABP比较,HLAP患者具有自身的特征,容易漏诊及复发,治疗关键是降低血TG浓度。Objective To compare the clinical features between hyperlipidemic acute pancreatitis（HLAP） and acute biliary pancreati-tis （ ABP）. Methods A total of 27 patients with HLAP and 61 patients with ABP were collected, and their clinical manifestations, la- boratory indicators,complications,and prognosis were compared. Results HLAP was more common in middle-aged male, manifested higher BMI, and often accompanied by fatty liver diseases and diabetes. Serum levels of ALT, AST, TBIL, DBIL, Ca^2＋ , the level of uri-nary amylase and the surgical rate were lower in HLAP patients than those in ABP patients. Serum levels of TG, TC, GLU and recur-rence rate were higher in HLAP patients than those in ABP patients （ P 〈 0.05 ）. However, HLAP and ABP showed no statistical differ-ence in clinical classification of severity, three kinds of scoring（ Ranson score, APACHE-Ⅱ rating, pancreas Balthazar CT score）, level of white blood cell, complications, hospitalized day and fatality rate （P 〉 0. 05 ）. Conclusion Compared with ABP, HLAP has its own characteristics, and is easy to be misdiagnosed and recur. The key of treatment is to reduce the blood TG concentration.

关 键 词：高脂血症性急性胰腺炎 胆源性急性胰腺炎 临床特征 

分 类 号：R657.51[医药卫生—外科学]