高脂血症急性胰腺炎临床特征分析  

Clinical Features of Hyperlipidemic Acute Pancreatitis

作　　者：曹举潮[1] 郝建志[1] 白鲲鹏[1] CAO Ju-chao;HAO Jian-zhi;BAI Kun-peng(Department of Emergency,The Second People′s Hospital of Guangdong,Guangzhou,510317)

机构地区：[1]广东省第二人民医院急诊科,510317

出　　处：《岭南急诊医学杂志》2020年第3期246-248,共3页Lingnan Journal of Emergency Medicine

基　　金：广东省援疆农村科技项目(KTP20190286)。

摘　　要：目的:总结高脂血症急性胰腺炎(HLAP)的临床特征,为HLAP的早期诊断与治疗提供参考。方法:回顾性分析2014年1月-2019年1月广东省第二人民医院诊治的急性胰腺炎(AP)患者642例的临床资料,根据病因分为高脂血症急性胰腺炎组(HLAP组,n=147)和非高脂血症急性胰腺炎组(NHLAP组,n=495),以并发症、实验室检测指标、治疗及预后为标准,比较两组患者的临床特征。结果:HLAP组患者糖尿病、高血压、脂肪肝的发病率显著高于NHLAP组患者(P<0.05);HLAP组患者血和尿淀粉酶(AMY)、血清丙氨酸氨基转移酶(ALT)、谷氨酰转肽(GGT)及总胆红素(TBIL)水平显著低于NHLAP组患者(P<0.05);HLAP组患者血甘油三酯(TG)与总胆固醇(TC)水平显著高于NHLAP患者(P<0.05);HLAP组手术治疗比例明显低于NHLAP组(12.2%vs. 40.0%,P<0.05);HLAP组的死亡率和复发率均显著高于NHLAP组(4.8%vs. 1.2%和40.1%vs. 6.1%,P均<0.05)。结论:HLAP与高血糖、高血脂等多种代谢异常因素密切相关,较非HLAP死亡率与复发率更高,入院后应对AP患者进行血脂检测,关注TC与TG变化,以助于临床上HLAP的诊断与治疗。Objective:To summarize clinical features of hyperlipidemic acute pancreatitis(HLAP),and to provide references for early diagnosis and treatment of HLAP. Methods:The clinical data of 642 patients with acute pancreatitis(AP)treated in the Second People′s Hospital of Guangdong were retrospectively analyzed from Jan 2014 to Jan 2019.They were classified as HLAP group(n=147)and NHLAP group(n=495)according to the cause of AP.Complications,laboratory test indexes,treatment and prognosis were used to compare clinical features between the two groups. Results:The incidence rates of complications such as diabetes,hypertension and fatty liver in HLAP group were significantly higher than those in the NHLAP group(P<0.05). The levels of serum AMY,urine AMY,ALT,GGT and TBIL in HLAP group were significantly lower than those in the NHLAP group(P<0.05). The levels of TG and TC in the HLAP group were significantly higher than those in the NHLAP group(P<0.05). The proportion of surgical treatment in HLAP group was significantly lower than that in the NHLAP group(12.2% vs. 40.0%,P<0.05). The proportions of death and recurrence in HLAP group were significantly higher than those in the NHLAP group(4.8% vs. 1.2% and 40.1% vs.6.1%,both P<0.05). Conclusion:HLAP is closely related to various metabolic abnormalities such as hyperglycemia and hyperlipidemia. Compared patients without HLAP,the mortality and recurrence rate are higher. Patients with AP should be tested for blood lipid after admission and the levels of serum TC and TG should be payed attention to,which is more conductive to clinical diagnosis and treatment of HLAP.

关 键 词：高脂血症 急性胰腺炎 临床特征 

分 类 号：R576[医药卫生—消化系统]