妊娠期高脂血症性急性胰腺炎临床特征及预后分析  

Clinical characteristics and prognosis of hyperlipidemic acute pancreatitis in pregnancy

作　　者：赵中原 岳学良 杨森[1] 闫一洋 武攀[1] 刘红山 ZHAO Zhong-yuan;YUE Xue-liang;YANG Sen;YAN Yi-yang;WU Pan;LIU Hong-shan(Department of Hepatobiliary,Henan University People's Hospital,Henan Provincial People’s Hospital,Zhengzhou,Henan 450003,China)

机构地区：[1]河南大学人民医院河南省人民医院肝胆外科,河南郑州450003

出　　处：《中华实用诊断与治疗杂志》2021年第4期391-393,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省医学科技攻关计划省部共建项目(SB201901079)。

摘　　要：目的探讨妊娠期高脂血症性急性胰腺炎(hyperlipidemia acute pancreatitis, HLAP)的临床特征、主要病因及预后。方法 41例妊娠期急性胰腺炎患者,按病因分为HLAP组20例和非HLAP组21例,记录并比较2组一般资料,采用多因素logistic回归分析妊娠期HLAP的危险因素。比较2组患者病情严重程度、预后情况及母婴结局。结果 41例妊娠期急性胰腺炎患者HLAP发生率为48.78%。HLAP组孕前高脂血症(35.0%)、孕期体质量增长过多(45.0%)发生率高于非HLAP组(4.76%、14.29%)(P<0.05)。孕前高脂血症(OR=15.304,95%CI:1.533~152.738,P=0.02)、孕期体质量增长过多(OR=6.863,95%CI:1.356~34.731,P=0.02)是妊娠期发生HLAP的独立危险因素。HLAP组患者中、重度急性胰腺炎(90.0%)、胸腔积液(60.0%)、局部并发症(50.0%)、全身炎症反应综合征(60.0%)、器官衰竭(45.0%)发生率高于非HLAP组(14.3%、9.5%、4.8%、9.5%、9.5%)(P<0.05),胎儿窘迫(60.0%)、终止妊娠(75.0%)比率高于非HLAP组(19.0%、38.1%)(P<0.05)。结论高脂血症是妊娠期急性胰腺炎的首要病因,孕前高脂血症、孕期体质量增长过多是妊娠期发生HLAP的独立危险因素;相对于妊娠期非HLAP,HLAP的母婴结局更差。Objective To investigate the clinical features, main causes and prognosis of hyperlipidemic acute pancreatitis(HLAP) in pregnancy. Methods Forty-one patients with acute pancreatitis in pregnancy were divided into HLAP group(n=20) and non-HLAP group(n=21) according to etiology. The general data of two groups were recorded and compared. The risk factors of HLAP in pregnancy were analyzed by multivariate logistic regression. The severity of disease, prognosis and maternal and infant outcomes were compared between two groups. Results The incidence of HLAP in 41 patients with acute pancreatitis in pregnancy was 48.78%. The incidence of hyperlipidemia before pregnancy and excessive weight gain during pregnancy were higher in HLAP group(35.0%, 45.0%) than those in non-HLAP group(4.76%, 14.29%)(P<0.05). Hyperlipidemia before pregnancy(OR=15.304, 95%CI: 1.533-152.738, P=0.02) and excessive weight gain during pregnancy(OR=6.863, 95%CI: 1.356-34.731, P=0.02) were the independent risk factors of HLAP in pregnancy. The incidences of moderate/severe acute pancreatitis(90.0%), pleural effusion(60.0%), local complications(50.0%), systemic inflammatory response syndrome(60.0%), organ failure(45.0%), fetal distress(60.0%) and termination of pregnancy(75.0%) in HLAP group were higher than those in non-HLAP group(14.3%, 9.5%, 4.8%, 9.5%, 9.5%, 19.0%, 38.1%)(P<0.05). Conclusion Hyperlipidemia is the primary cause of acute pancreatitis in pregnancy. Hyperlipidemia before pregnancy and excessive weight gain in pregnancy are the independent risk factors of HLAP in pregnancy. Compared with non-HLAP in pregnancy, the maternal and infant outcomes of HLAP are worse.

关 键 词：急性胰腺炎 妊娠 高脂血症 预后 

分 类 号：R714.255[医药卫生—妇产科学]