重症急性胰腺炎并发胰性脑病的临床特点及相关影响因素分析  

Severe Acute Pancreatitis Complicated with Pancreatic Encephalopathy:Clinical Characteristics and Its Influencing Factors

作　　者：张昆鹏[1] 张晓愉[2] 贾军红[1] 任怀珍[1] 李少一[1] 

机构地区：[1]邢台市人民医院肝胆外科,河北邢台054001 [2]邢台市人民医院神经内科,河北邢台054001

出　　处：《现代生物医学进展》2016年第21期4109-4112,共4页Progress in Modern Biomedicine

基　　金：邢台市科技计划项目(2015ZC089)

摘　　要：目的：探究重症急性胰腺炎并发胰性脑病（PE）的临床特点及相关影响因素分析。方法：本研究于2008年3月～2015年3月期间,选择我院收治的重症急性胰腺炎患者93例为研究对象,根据患者是否并发PE临床症状将其分为PE组和非PE组。收集所有患者基本资料、实验室检查指标及病原学培养检查资料,采用logistics回归对PE发病的影响因素进行分析。结果：93例重症急性胰腺炎中23例被诊断为PE,发病率为24.73%,临床主要表现为兴奋性、烦躁不安、谵妄等症状;PE组患者APACHEⅡ评分、MODS发生率、肌酐、甘油三脂水平及真菌感染率均高于非PE组,差异有统计学意义（P〈0.05）;多因素logistics回归显示,高APACHEⅡ评分和高甘油三脂是PE发生的危险因素（OR=3.221,2.973;均P〈0.05）。结论：重症急性胰腺炎并发PE的发病率较高,临床有较高的APACHEⅡ评分、MODS发生率、肌酐、甘油三脂水平及真菌感染率,其中高APACHEⅡ评分和高甘油三脂是PE发生的危险因素。Objective： To explore the clinical characteristics of severe acute pancreatitis complicated with pancreatic encephalopathy（PE） and its influencing factors. Methods： A total of 93 patients with severe acute pancreatitis, who were admitted to Xingtai People＇s Hospital from March 2008 to March 2015, were chosen as research subjects and divided into PE group and non-PE group according to whether complicated with the clinical symptoms of PE or not. The base information, laboratory examination indexes and etiology training examination results of patients were collected; the risk factors of PE were analyzed by logistics regression. Results： Among the 93 research subjects, 23 cases of PE, and the incidence was 24.73%, whose main clinical symptoms were excitability, dysphoria and delirium.APACHEⅡ score, the incidence of MODS, the levels of creatinine and triglyceride and the incident of fungal infection in PE group were significantly higher than those in non-PE group, the differences were statistically significant（P〈0.05）. The multivariate logistics regression showed that the high APACHEⅡ score and the high level of triglyceride were the risk factors of PE（OR=3.221, 2.973; P〈0.05）.Conclusion： The incidence of patients with severe acute pancreatitis complicated with PE is high, and the patients have high APACHE Ⅱscore, incidence of MODS, levels of creatinine and triglyceride and the incident of fungal infection, among which the high level of APACHE Ⅱ score and triglyceride are the risk factors of PE.

关 键 词：急性胰腺炎 胰性脑病 临床特征 影响因素 

分 类 号：R576[医药卫生—消化系统]