急性胰腺炎后胰腺内分泌变化临床研究  

Clinical Study on Endocrine Changes in Pancreas after Acute Pancreatitis

作　　者：曲鹏飞[1] 王红[1] 韩俊泉[1] 杜瑞斌[1] 肖继[1] 崔乃强[2] QU Peng-fei;WANG Hong;HAN Jun-quan(The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300150 , China)

机构地区：[1]天津中医药大学第二附属医院普外科,天津300150 [2]天津市南开医院,天津300193

出　　处：《中国中西医结合外科杂志》2017年第6期583-587,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金项目(81202780)

摘　　要：目的:观察研究急性胰腺炎后胰腺内分泌变化。方法:选取既往无糖尿病病史的急性胰腺炎住院患者60例为急性胰腺炎组,既往无糖尿病病史正常体检者30人为对照组。测定入院时、入院次日晨空腹、入院后第3 d晨空腹、入院后第7 d晨空腹血糖、胰岛素和C肽,比较两组结果。结果:急性胰腺炎组血糖在入院时[(7.2±1.4)mmol/L]、24 h[(7.3±2.3)mmol/L]、3 d[(9.4±1.6)mmol/L]较对照组[(4.3±1.8)mmol/L]升高,具有统计学意义,入院后7 d血糖([4.5±1.2)mmol/L]较对照组无明显升高。急性胰腺炎组血清胰岛素在入院后24 h([10.0±3.0)μIU/m L]、3 d([9.5±2.6)μIU/m L]较对照组[(11.4±0.6)μIU/m L]降低,具有统计学意义(P<0.05),入院时[(11.8±2.7)μIU/m L]及入院后7 d[(11.9±2.7)μIU/m L]血清胰岛素较对照组无明显变化。急性胰腺炎组血清C肽在入院后24 h[(1.3±0.6)ng/m L]、3 d[(1.3±0.3)ng/m L]较对照组[(1.5±0.5)ng/m L]降低,入院时[(1.4±0.3)ng/m L]及入院后7 d[(1.5±0.3)ng/m L]血清C肽较对照组无明显变化。急性胰腺炎组血糖值随着发病时间延长呈现先升后降趋势,发病后7 d血糖基本恢复。血清胰岛素及C肽值则呈现先降后升趋势。结论:急性胰腺炎患者随着病情发展血糖先升后降,胰岛素及C肽先降后升,提示急性胰腺炎患者胰腺内分泌功能失调。Objective To observe the changes of pancreatic endocrine after acute pancreatitis(AP).Methods Sixty cases of hospitalized patients with AP were selected as observation group,meanwhile,30healthy people were selected as control group.All of them were without the history of diabetes mellitus.The fasting blood glucose,insulin and C peptide were measured on the morning of the day,next day,day3and day7after admission.The results were compared between the observation group and control group.Results The values of fasting blood glucose in the observation group at admission,24h later and3d after admission were(7.2±1.4),(7.3±2.3)and(9.4±1.6)mmol/L,respectively,which were higher than that in the control group[(4.3±1.8)mmol/L](P<0.05).However,there was no statistical significance on day7between two groups.The levels of serum insulin in observation group were(10.0±3.0)μIU/mL at24h,(9.5±2.6)μIU/mL3d after admission.Compared with the control group[(11.4±0.6)μIU/mL],there was statistical significance(P<0.05),but it was not statisticly significant compared with the control group at admission and on day7after admission.The levels of serum C peptide in observation group were(1.3±0.6)and(1.3±0.3)ng/mL on day1and3after admission,which were decreased compared with the control group[(1.5±0.5)ng/mL].The levels of serum C peptide in observation group at admission[(1.4±0.3)ng/mL]and on day7after admission[(1.5±0.3)ng/mL]had no significant difference compared with control group.In the AP group,the blood sugar increased first and then decreased after the onset time,and the blood sugar basically recovered7d after the onset.The serum insulin and C peptide showed the trend of decreasing first and then rising.Conclusion With the development of AP,the level of blood sugar rises first and then drops,however,the levels of insulin and C peptide fall first and then rise.It is suggested that there is dysfunction of pancreatic endocrine in patients with AP.

关 键 词：急性胰腺炎 胰腺内分泌 内分泌功能 

分 类 号：R657.51[医药卫生—外科学]