合并脂肪肝对重症急性胰腺炎治疗效果的影响  

Complication with fatty liver could affect the treatment of severe acute pancreatitis

作　　者：施英瑛[1] 王伟岸[1] 王文静[1] 贺春燕[1] 曹金华 王寰[1] 吴丽莎[1] 

机构地区：[1]武警总医院,北京100039

出　　处：《热带医学杂志》2017年第11期1503-1506,共4页Journal of Tropical Medicine

摘　　要：目的探讨合并脂肪肝对重症急性胰腺炎患者治疗效果的影响。方法回顾性分析2015年2月-2016年10月在本院接受治疗的重症急性胰腺炎患者的临床资料,根据其是否合并脂肪肝分为未合并脂肪肝组和合并脂肪肝组,两组患者均接受奥曲肽等常规治疗。观察两组患者治疗效果,比较两组患者治疗前后炎症因子、血尿淀粉酶和免疫功能的差别。结果未合并脂肪肝组患者治疗的有效率明显高于合并脂肪肝组(χ2=5.165,P=0.023);未合并脂肪肝组患者血、尿淀粉酶恢复正常时间均较合并脂肪肝组短,差异有统计学意义(t=4.329、4.731,P<0.001);两组患者治疗前Ig G、Ig A和Ig M等免疫功能指标无明显差别,治疗后,未合并脂肪肝组患者的Ig G、Ig A和Ig M水平高于合并脂肪肝组,差异有统计学意义(P<0.001);两组患者治疗前血清炎症因子水平无差别,治疗后,未合并脂肪肝组患者的IL-6、CRP和TNF-α水平明显低于合并脂肪肝组患者,差异有统计学意义(P<0.001)。结论合并脂肪肝对重症急性胰腺炎患者的治疗效果有较明显的负性影响,应作为临床治疗考虑的重要因素之一。Objective To investigate whether the complication with fatty liver could affect the treatment of severe acute pancreatitis. Methods The clinical data of patients with severe acute pancreatitis treated in our hospital from February 2015 to October 2016 were retrospectively analyzed. According to complication with ,the patients were divided into non-fatty liver group and fatty liver group. The two groups were treated with octreotide and other conventional treatment. The therapeutic effects of the two groups were observed and compared. The differences of inflammatory factors ,blood amylase and immune function were compared between the two groups before and after treatment. Results The non-fatty liver group patients had significantly higher efficiency than that of fatty liver group（χ2=5.165,P=0.023）. The length of time for serum and urine amylase returned to normal in the patients of non-fatty liver group were shorter than that of the fatty liver group（t=4.329,4.731,P〈0.001）. Before treatment,IgG,IgA and IgM levels and other immune function indexes were not significantly different between two groups;after treatment,the IgG,IgA and IgM levels of the non-fatty liver group were higher than those of the fatty liver group（P〈0.001）. There was no difference in the level of serum inflammatory cytokines before treatment in the two groups. After treatment,the levels of IL-6,CRP and TNF-α of the non-fatty liver group were significantly lower than those of the patients with fatty liver（P〈0.001）. Conclusion Fatty liver has a significant negative effect on the treatment of patients with severe acute pancreatitis ,which should be considered as one of the important factors in clinical treatment.

关 键 词：脂肪肝 胰腺炎 奥曲肽 淀粉酶 炎症因子 

分 类 号：R576[医药卫生—消化系统]