高脂血症性重症胰腺炎患者胰岛素降脂治疗及其与预后的关系  

Correlation of insulin lipid - lowering therapy with the prognosis of hypertriglyceridemic severe pancreatitis

作　　者：王玉柱[1] 秦涛[1] 张宏伟[1] 胡明星[1] 付强[1] 刘传江[1] 薛焕洲[1] 

机构地区：[1]郑州大学人民医院(河南省人民医院)肝胆胰腺外科,450003

出　　处：《中华实验外科杂志》2016年第6期1656-1658,共3页Chinese Journal of Experimental Surgery

摘　　要：目的探讨胰岛素在高脂血症性重症胰腺炎中的降脂作用与预后的关系。方法高脂血症性重症胰腺炎患者40例，人院时甘油i酯水平均〉5．65mmol／L。根据入院血糖是否大于10mmol／L分为胰岛素治疗组（22例）和常规治疗组（18例），观察两组甘油三酯下降水平、腹痛消失和肠功能恢复时间、并发症及住院时间等。结果胰岛素治疗组在二三酰甘油水平下降低于5．65mmol／L、腹痛消失及肠功能恢复时间分别为：（3．41±1．74）、（3．64±1．43）、（8．09±2．81）d，较常规治疗组（5．89±1．37）、（5．28±1．36）、（10．00±2．72）d显著缩短，两组差异有统计学意义（P〈0．05）；而住院时间胰岛素治疗组为（31．1±28．2）d，较常规治疗组[（19．7±6．1）d]差异无统计学意义（P〉0．05），除胰岛素治疗组1例死于继发真菌血症外，其余患者均顺利出院。两组在并发症和病死率方面差异无统计学意义（P〉0．05）。结论静脉胰岛素降脂治疗能迅速降低三酰甘油水平、缓解腹痛、缩短肠功能恢复时间，但不能缩短住院时间和改善预后。Objective To assess the correlation of insulin lipid - lowering effect with the prognosis of hypertriglyceridemic severe pancreatitis. Methods Retrospective the results of forty patients were ad- mitted to our hospital with hypertriglyceridemic severe pancreatitis, All patient＇ s with triglyeeride levels 〉 5.65 mmol/L when admission, According the blood glucose levels divide into regular insulin （ RI ） and conventional treatment groups. The day of decline triglyceride levels below 5.65 retool/L, abdominal pain deprivation and recovery of intestinal function;complications and time of discharge were observed. Results Times courses of decline triglyceride levels below 5.65 retool/L, abdominal pain disappear and recovery of intestinal function were respectively, （ 3.41 ±_ 1.74 ）, （ 3.64 ± 1.43 ） and （ 8.09 ± 2. 81 ） days in RI group, and （5. 89 ± 1.37） , （5. 28 ± 1.36） and （ 10. 00 ±2.72） clays in Conventional treatment group, the differences were significant between the two groups （ P 〈 0. 05 ） ; But there is no significant difference concerning the average length of hospital stay respectively was （ 31.1 ± 28.2 ） d with （ 19. 7 ± 6. 1 ） d, complications and fatality rate in RI and conventional group （ P 〉 0. 05 ）. One patient in RI group died of secondary fungal infection. Conclusion For patients with hypertriglyceridemia severe pancreatitis, intra- venous infusion of insulin could lastly decline the levels of triglyceridemia, improve the symptoms of early phase, but can＇ t shorten the time of stay and improve prognosis.

关 键 词：高脂血症 重症胰腺炎 胰岛素 降脂治疗 预后 

分 类 号：R576[医药卫生—消化系统]