血浆置换对高脂血症胰腺炎的疗效影响因素分析  

Influential factors analysis of the efficacy of plasma exchange in hyperlipidemic pancreatitis patients

作　　者：黄国海 许少英[1] 黄国鑫 李绪城[1] HUANG Guo-hai;XU Shao-ying;HUANG Guo-xin;LI Xu-cheng(Department of Blood Purification Center,Shantou central hospital,Shantou 515041,China;Clinical Research Center,Shantou central hospital,Shantou 515041,China)

机构地区：[1]汕头市中心医院血液净化中心,汕头515041 [2]汕头市中心医院临床医学研究中心,汕头515041

出　　处：《中国血液净化》2021年第8期522-525,共4页Chinese Journal of Blood Purification

摘　　要：目的使用Logistic回归分析影响血浆置换(plasma exchange,PEX)在高脂血症胰腺炎(hyperlipidemic pancreatitis,HLP)患者疗效的相关危险因素。方法回顾性分析2015年1月-2020年12月汕头市中心医院血液净化中心行PEX治疗的58例HLP患者的临床资料。比较患者治疗前后的腹部CT结果,根据复查CT结果分为改善及进展2组,比较2组的临床资料差异。应用Logistic回归分析评估HLP影像学进展的危险因素。结果共纳入患者58例,男性47例(81.0%),平均年龄为(39.0±8.8)岁,治疗前三酰甘油(TG)(16.7±4.3)mmol/L,经PEX治疗后TG(6.6±2.8)mmol/L,差异有统计学意义(t=19.524,P<0.001)。复查腹部CT结果显示影像学有改善者28例(48.3%),进展者30例(51.7%)。与影像学改善组的患者比较,影像学进展组的患者血清葡萄糖更高(t=2.406,P=0.019)、血淀粉酶>300u/L者占比更高(χ^(2)=4.459,P=0.035)、Balthazar CT为D/E级者占比更高(χ^(2)=4.351,P=0.037)、治疗后TG更高(t=2.441,P=0.018),差异均有统计学意义。多因素Logistic回归分析结果显示影响HLP影像学进展的独立危险因素包括:血淀粉酶>300u/L(OR=3.781,95%CI:1.124-12.723,P=0.032),治疗后TG(OR=1.309,95%CI:1.040-1.646,P=0.022)。结论PEX可降低HLP患者的血脂水平,影响HLP影像学进展的独立危险因素包括血淀粉酶及治疗后TG。Objective To identify the risk factors on the efficacy of plasma exchange in hyperlipidemic pancreatitis patients by Logistic regression.Methods We retrospectively analyzed the clinical data of 58 hyperlipidemic pancreatitis patients who underwent plasma exchange treatment in the Blood Purification Center of Shantou Central Hospital from January 2015 to December 2020.According to the comparison of the abdominal CT results both before and after the plasma exchange,enrolled patients were divided into improved group and progressed group.Compare the clinical data between the two groups.Logistic regression analysis was performed to analyze the risk factors which affected the imaging progression of hyperlipidemic pancreatitis patients.Results 58 patients recruited in this study,including 47 males and 11 females,mean age was 39.0±8.8 years.There was a significant difference in the TG level of patients before and after plasma exchange treatment(16.7±4.3 mmol/L vs.6.6±2.8 mmol/L,t=19.524,P<0.001).The post-treatment abdominal CT results showed 28 cases(48.3%)in the improved group and 30 cases(51.7%)in the progressed group.Compared with patients in the imaging improvement group,patients in the imaging progressed group had higher serum glucose(t=2.406,P=0.019),a higher proportion of serum amylase>300 U/L(χ^(2)=4.459,P=0.035),a higher proportion of Balthazar CT grade D/E(χ^(2)=4.351,P=0.037),and higher TG after treatment(t=2.441,P=0.018).Multivariate Logistic regression analysis showed that the independent risk factors affecting the imaging progression of hyperlipidemic pancreatitis included serum amylase>300u/L(OR=3.781,95%CI:1.124-12.723,P=0.032),and post-treatment TG(OR=1.309,95%CI:1.040-1.646,P=0.022).Conclusion Plasma exchange can significantly reduce the level of blood lipid,and the independent risk factors affecting the imaging progression of hyperlipidemic pancreatitis include serum amylase and post-treatment TG.

关 键 词：血浆置换 高脂血症胰腺炎 影响因素 

分 类 号：R459.5[医药卫生—治疗学]