高脂血症性急性、胆源性胰腺炎的临床对比  

Clinical Comparison of Hyperlipidemic Acute and Biliary Pancreatitis

作　　者：张杰[1] 沈洪章[1] 杨传春[1] 杨斌[1] ZHANG Jie;SHEN Hongzhang;YANG Chuanchun;YANG Bin(Department of Gastroenterology,Taizhou People’s Hospital,Taizhou Jiangsu 225300,China)

机构地区：[1]泰州市人民医院消化内科,江苏泰州225300

出　　处：《中国继续医学教育》2020年第13期102-104,共3页China Continuing Medical Education

摘　　要：目的急性高脂性胰腺炎发病呈上升趋势,其与急性胆源性胰腺炎的临床特征有所不同,通过比较以提高对高脂性胰腺炎的重视。方法 2017年6月-2019年6月,随机选取30例急性高脂性胰腺炎、30例急性胆源性胰腺炎病例,对组间患者的临床病情资料进行详细记录,主要涉及内容:患者的身体质量指数、临床分型、临床经过、实验室指标等,整理患者的所有数据资料并进行分析;比较组间的血液生化检验指标、住院时间、复发率和预后情况。结果研究组的甘油三酯(17.77±2.33)mmol/L、血糖(15.23±2.22)mmol/L、尿酸(387.77±42.11)mmol/L指标比对照组均更高,且研究组的丙氨酸转氨酶(36.67±10.09)U/L、碱性磷酸酶(55.32±10.09)U/L、总胆红素(28.76±9.22)μmol/L、直接胆红素(8.66±1.45)μmol/L、淀粉酶(219.91±67.76)U/L指标比对照组均更低,P<0.05,指标之间的差异存在统计学意义。研究组的血尿淀粉酶正常检出率比对照组更高,P<0.05,指标之间的差异存在统计学意义。研究组的住院时间[(14.44±2.11)d]与对照组的住院时间[(14.12±2.09)d]之间指标差异不存在统计学意义,P>0.05;研究组的疾病复发(1.22±0.11)次对照组的疾病复发[(1.21±0.12)d]之间指标差异不存在统计学意义,P>0.05;研究组的死亡率16.67%(5例)比对照组(0.00%)更高,P<0.05,指标差异存在统计学意义。结论和胆源性胰腺炎相比较,高脂性胰腺炎多见于肥胖、高血脂人群,发作时胰酶升高可以不明显,但病情容易向重症化发展。在临床工作中,对于高脂性胰腺炎需予以高度重视。Objective The incidence of acute hyperlipid pancreatitis is on the rise, which is different from the clinical features of acute biliary pancreatitis. The comparison is made to improve the attention of highfat pancreatitis. Methods From June 2017 to June 2019, 30 cases of acute hyperlipid pancreatitis and 30 cases of acute biliary pancreatitis were randomly selected. The clinical data of the patients in the group were recorded in detail. The main content involved: the patient’s Body mass index, clinical classification, clinical history, laboratory indicators, etc., all data of patients were sorted and analyzed;blood biochemical test indicators, hospitalization time, recurrence rate and prognosis were compared between the groups. Results The indexes of triglyceride(17.77±2.33) mmol/L, blood glucose(15.23±2.22) mmol/L and uric acid(387.77±42.11) mmol/L in the study group were higher than those in the control group. Moreover, alanine transaminase(36.67±10.09) U/L, alkaline phosphatase(55.32±10.09) U/L, total bilirubin(28.76±9.22) mol/L, direct bilirubin(8.66±1.45) mol/L, amylase(219.91±67.76) U/L were all lower in the study group than in the control group, and the differences between the indicators were statistically significant(P<0.05). The normal detection rate of hematural amylase in the study group was higher than that in the control group(P<0.05). There was no statistically significant difference between the length of stay in the study group [(14.44±2.11) d] and the control group [(14.12±2.09) d], P>0.05. There was no statistically significant difference between the disease recurrence in the study group(1.22±0.11) and that in the control group [(1.21±0.12) d], P>0.05. The mortality rate of the study group was 16.67%(5 cases) higher than that of the control group(0.00%), with P<0.05,indicating statistically significant differences. Conclusion Compared with biliary pancreatitis, hyperlipid pancreatitis is more common in obese and hyperlipidemia. The increase of pancreatic enzyme may not be obvious at

关 键 词：高脂血症性急性胰腺炎 胆源性胰腺炎 临床 对比评价 复发率 预后情况 

分 类 号：R657[医药卫生—外科学]