38例非胰腺炎相关高脂肪酶血症患者的临床特征分析  

Clinical impact of non-pancreatic conditions with hyperlipasaemia

作　　者：李素文[1] 林祥宏[2] 鲍峻峻[1] 梅俏[1] 许建明[1] LI Su-wen;LIN Xiang-hong;BAO Jun-jun(Department of Gastroenterology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Department of Clinical laboratory,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]合肥安徽医科大学第一附属医院消化内科,合肥230022 [2]合肥安徽医科大学第一附属医院检验科,合肥230022

出　　处：《肝胆外科杂志》2021年第2期99-101,共3页Journal of Hepatobiliary Surgery

基　　金：安徽省教育厅高等学校省级质量工程教学研究项目课题(项目编号:2015jyxm770);安徽医科大学校科研基金(项目编号:2015xkj047)。

摘　　要：目的分析非胰腺炎相关高脂肪酶血症患者的临床特点,提高临床诊疗水平。方法回顾分析2018年1月至2019年3月安徽医科大学第一附属医院38例非胰腺炎相关高脂肪酶血症住院患者临床资料,分析其临床表现、实验室生化检查及基础疾病等资料。结果38例非胰腺炎相关高脂肪酶血症患者,其中意识不清10例,余患者39.3%(11/28)表现有非胰腺炎相关的腹痛。38例患者血清脂肪酶平均升高5.93±3.68倍,平均进行1.37±0.59次腹部影像学检查;47.4%(18/38)患者接受了抑制胰酶治疗。常见的基础疾病包括肾功能不全(36.8%,14/38)和发热伴血小板减少综合征(26.3%,10/38)。肾功能不全组血清脂肪酶大于非肾功能不全组(P<0.05)。23.7%(9/38)高脂肪酶血症患者同时合并高淀粉酶血症。结论高脂肪酶血症见于多种基础疾病,常合并高淀粉酶血症,详细病史和影像学检查是避免过度诊疗的关键。Objective The aim of this study was to discover the underlying causes and their clinical impact of non-pancreatic conditions with hyperlipasaemia and to improve the ability of diagnosis and treatment.Methods Between January,2018 and March,2019 data were collected on inpatients at a regional referral centre.Patients were selected based on having elevated lipase,but without a diagnosis of acute pancreatitis or known pancreatobiliary disease.The clinical manifestations and laboratory results were observed.Results During the study period,38 patients without a diagnosis of pancreatitis or known pancreatobiliary disease had elevated lipase>3 times the upper limit of normal.Beside 10 patients with unconsciousness,39.3%(11/28)of the remaining patients had nonspecific abdominal pain.The serum lipase of 38 patients increased by 5.93±3.68 times.An average of 1.37±0.59 abdominal imaging examinations were performed in these patients.47.3%(18/38)patients received pancreatic exocrine enzyme suppression therapy.The main underlying diseases of these patients were renal insufficiency(36.8%,14/38),severe fever with thrombocytopenia syndrome(10/38,26.3%),et al.23.7%(9/38)patients had elevated serum amylase>3 times the upper limit of normal.Conclusion In conclusion,serum lipase may be greater than three times the upper limit of normal in patients with renal insufficiency or severe fever with thrombocytopenia syndrome.Mmedical history and abdominal imaging procedure can help avoid over treatment.

关 键 词：高脂肪酶血症 脂肪酶 发热伴血小板减少综合征 

分 类 号：R658[医药卫生—外科学]