急性胰腺炎短期复发的影响因素研究  

Influence Factor of Acute Pancreatitis Recurrence in the Short Term

作　　者：袁帅[1] 周海华[1] 

机构地区：[1]南方医科大学附属小榄医院,广东省中山市528415

出　　处：《中国全科医学》2017年第8期943-947,共5页Chinese General Practice

摘　　要：目的探讨急性胰腺炎短期复发的危险因素。方法选取2011年5月—2013年12月在南方医科大学附属小榄医院住院的首次发作急性胰腺炎患者130例,经治疗好转出院后,对其进行为期12个月的随访,根据是否出现复发性急性胰腺炎,将患者分为复发组和未复发组。记录两组患者临床资料,分析急性胰腺炎短期复发的危险因素。结果复发组36例,未复发组94例,复发率为27.7%。两组性别、年龄、饮酒率、体质指数(BMI)、胆石症、经内镜逆行性胰胆管造影术(ERCP)检查率、改良CT严重指数(MCTSI)评分、Rason评分、C反应蛋白(CRP)、血清钙、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖水平比较,差异均无统计学意义(P>0.05);两组三酰甘油(TG)、餐后2 h血糖水平比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,糖耐量受损是急性胰腺炎短期复发的危险因素〔OR=1.473,95%CI(1.027,3.342),P<0.05〕。急性胰腺炎合并糖耐量受损者1年复发率为68.8%,未合并糖耐量受损者1年复发率为31.2%,两者复发率比较,差异有统计学意义(χ~2=15.821,P=0.013)。结论糖耐量受损是急性胰腺炎短期复发的独立危险因素,控制急性胰腺炎患者餐后2 h血糖水平可能有助于降低短期复发率。Objective To investigate the risk factors of short- term recurrence of acute pancreatitis.Methods One hundred and thirty patients with first- attack acute pancreatitis in the Affiliated Xiaolan Hospital of Southern Medical University from May 2011 to December 2013 were selected for the research.A follow- up of 12 months was given to patients after discharge.Patients were divided into recurrence group and non- recurrence group according to whether there was acute pancreatitis recurrence.The clinical data were recorded,and the risk factors of short- term recurrence of acute pancreatitis were analyzed.Results There were 36 patients in the recurrence group and 94 in non- recurrence group.The recurrence rate was 27.7%.There was no significant difference in gender,age,drinking rate,body mass index（ BMI）,the incidence of cholelithiasis and endoscopic retrograde cholangiopancreatography（ ERCP）,MCTSI score,Rason score,C- reactive protein（ CRP）, serum calcium,total calcium cholesterol（ TC）, high density lipoprotein cholesterol（ HDL-C）, low density lipoprotein cholesterol（ LDL-C） and fasting blood glucose between two groups（ P〉0.05）.There was significant difference in triglyceride（ TG） and postprandial 2- hour blood glucose between two groups（ P〈0.05）.Multivariate Logistic regression analysis showed that impaired glucose tolerance was a risk factor of the recurrence of acute pancreatitis in the short term 〔OR = 1.473,95% CI（ 1.027,3.342）,P〈0.05〕.The recurrence rate of acute pancreatitis combined with impaired glucose tolerance in 1 year was68.8%,while the recurrence rate of not combined with impaired glucose tolerance was 31.2%, and there was significant difference in the two recurrence rates（ χ~2=15.821,P =0.013）.Conclusion Impaired glucose tolerance is an independent risk factor of the recurrence of acute pancreatitis in the short term.Controlling postprandial 2- hour blood glucose level of patients with acute pancreatitis may help to reduce the short- term recurrence

关 键 词：胰腺炎 复发 糖耐量受损 危险因素 

分 类 号：R576[医药卫生—消化系统]