血液净化治疗高脂血症性急性胰腺炎临床疗效观察  

Therapeutic effects of blood purification on hyperlipidemic acute pancreatitis

作　　者：余追[1] 李光[1] 张迪[1] 严娟娟[1] 

机构地区：[1]武汉大学人民医院重症医学科,430060

出　　处：《临床内科杂志》2013年第12期837-839,共3页Journal of Clinical Internal Medicine

摘　　要：目的 探讨血液净化对高脂血症性急性胰腺炎患者的治疗作用.方法 高脂血症性急性胰腺炎患者18例作为血液净化组,在常规治疗的基础上加用血液灌流联合连续性静脉-静脉血液滤过（CVVH）.收集同期本院其他科室收治的15例高脂血症性急性胰腺炎患者15例作为常规治疗组,未进行血液净化治疗.比较两组患者入院时和入院48小时后血清淀粉酶（AMY）、三酰甘油（TG）浓度、急性生理与慢性健康评分（APACHEⅡ）及死亡数.结果 血液净化组在首次血液灌流联合连续性静脉-静脉血液滤过后血清淀粉酶、三酰甘油和急性生理与慢性健康评分均明显下降,差异有统计学意义（P＜0.05）.入院48小时后,两组患者上述指标比较差异有统计学意义（P＜0.05）.血液净化组死亡3例（16.7％）,常规治疗组死亡4例（26.7％）,两组比较差异有统计学意义（P＜0.05）.结论 血液净化治疗可以较快降低HLAP患者血清淀粉酶和三酰甘油水平,缓解病情,降低死亡率.Objectives To observe the therapeutic effects of blood purification on patients with hyperlipidemic acute panereatitis （HLAP）. Methods Eighteen HLAP patients of blood purification （BP） group from department of critical care medicine received hemoperfusion （HP） combined with continuous veno-venous hemofiltration（CVVH） on the conventional therapy. Fifteen HLAP patients from department of gastroenterology and department of hepatobiliary surgery were given just conventional therapy. Amylase activity （ AMY）, triglyceride （ TG）, Acute Physiology and Chronic Health Evaluation 11 （ APACHEII）, average days of hospitalization and mortality were compared between the two groups. Results After treatment by HP combined with CVVH,patients＇ AMY[ （1581 ＋ 1022） U/L vs （1141 ＋826）U/L,P 〈0.05） ] as well as ser- um levels of TG[ （41.29 ＋ 12.67 ） mmol/L vs （ 13.22 ＋ 3.55 ） mmol/L] and APACHEII[ （ 17.38 ± 2.79 ） vs （ 14.50 ±2.64） ,all P 〈0.05） decreased significantly. There were significant difference of AMY[ （433 ± 284） U/L vs （ 1178 ± 764 ） U/L ], TG [ （ 10. 12 ± 2.85 ） vs （ 33.94 ± 12.70 ） mmol/L ] and APACHEII [ （ 12.61 ± 2.45 ） vs （ 15.06 ± 2.96）, all P 〈 0.05 ] between the two groups 48hrs later after hospitalization. Compared with BP group, conventional group had higher mortality [ （4/15,26.7 % ） vs （ 3/18,16.7 % ）, P 〈 0.05 ]. Conclusion Blood purification（ HP combined with CVVH or CVVHDF） can decrease serum TG, AMY, APACHE II and mortality in HLAP patients.

关 键 词：血液净化 血液灌流 连续静脉-静脉血液滤过 高脂血症性急性胰腺炎 急性生理与慢性健康评分Ⅱ 

分 类 号：R589.2[医药卫生—内分泌]