重症急性胆源性胰腺炎与重症高脂血症性急性胰腺炎的临床特点分析  

作　　者：王爱国 潘文胜 

机构地区：[1]浙江省缙云县人民医院,321400 [2]浙江省人民医院,310014

出　　处：《浙江临床医学》2021年第2期248-249,共2页Zhejiang Clinical Medical Journal

摘　　要：目的探讨胆源性重症急性胰腺炎(SAP)与高脂血症性SAP患者临床及预后差异性。方法总结分析85例SAP患者,其中,胆源性SAP患者55例,高脂血症性SAP患者30例,通过对比分析患者年龄、住院时间、Ranson评分、CT严重程度指数(CTSI)、血清C反应蛋白(CRP)、血清白蛋白及相关并发症发病率。结果胆源性SAP组患者55例,平均年龄61.02岁,高脂血症SAP组患者30例,平均年龄39.6岁,两者存在明显的统计学差异性(P=0.001)。胆源性SAP组患者住院平均费用38,604.85元,高脂血症SAP组患者住院费用51,999.12元,两者差异有统计学意义(P<0.001)。胆源性SAP组患者CTSI(6.10±0.18),高脂血症SAP组患者CTSI(8.58±0.39),两者差异存在统计学意义(P=0.01).胆源性SAP组患者血清CRP(176.46±3.49)mg/L,高脂血症SAP组患者血清CRP(246.80±5.10)mg/L,两者差异有统计学意义(P=0.03)。胆源性SAP组患者血清白蛋白水平(32.5±0.52)g/L,高脂血症SAP组患者血清白蛋白水平(24.70±1.49)g/L,两者差异有统计学意义(P<0.001).胆源性SAP组患者急性呼吸窘迫综合征(ARDS)发病率10.9%,高脂血症SAP组患者ARDS发病率20.0%,两组差异有统计学意义(P=0.03).胆源性SAP组患者急性肾功能衰竭发病率9.09%,高脂血症SAP组患者急性肾功能衰竭发病率20.0%,两组差异有统计学意义(P=0.01).结论高脂血症SAP患者相对年轻化,更易出现低蛋白血症,血清CRP水平更高,且这类患者急性肾功能衰竭、ARDS发生率相同,死亡率也会显著增加。需要更谨慎处理该种类型的SAP患者,早期积极有效的干预可以降低患者病死率,降低社会负担。Objective To find out clinical and prognostic difference between biliary severe acute pancreatitis(BSAP)and hypertriglyceridemic severe acute pancreatitis(HSAP)patients.Methods Out of 85 SAP patients were erfrolled into our study,in addition,55 cases of BSAP and 30 cases of HSAP,the age,hospital stay,hospital cost,Ranson score,CTSI,serum CRP,serum albumin and potential complications associated with SAP were compared.Results The mean age of BSAP and HSAP patients were 61.02 and 39.60 years old,respectively.There was significant difference between two groups(P=0.001).Hospital cost in HSAP was much higher than that ofBSAP group.(51,999.12 Yuan vs 38,604.85 Yuan,P<0.001).Serological test showed CRP in HSAP group was much higher compared to BSAP group(246.80±5.10)mg/L vs(176.46±3.49)mg/L,P=0.030,serum albumin in HSAP were much lower compared to that of BSAP group.(24.70±1.49)g/L vs(32.5±0.52)g/L,P<0.001.ARDS and acute renal failure were more likely to see in HSAP patients.(P=0.03,P=0.01).Conclusion Patients of HSAP group are much younger,and those patients are more likely to have low level of serum albumin and higher level of serum CRP.Additionally,HSAP patients have much higher risk of acute renal failure,ARDS and mortaUty.We need to pay more attention to HSAP patients and take effective treatment strategy to decrease its potential mortality and social medical burden.

关 键 词：重症急性胰腺炎 并发症 预后 

分 类 号：R57[医药卫生—消化系统]