幽门螺杆菌感染对重症急性胰腺炎患者预后的影响  

Effect of Helicobacter pylori infection on prognosis of severe acute pancreatitis

作　　者：贺文成[1] 张永根[1] 郑志刚[1] Wen-Cheng He;Yong-Gen Zhang;Zhi-Gang Zheng(Department of Critical Medicine,Pingxiang People’s Hospital,Pingxiang 337055,Jiangxi Province,China)

机构地区：[1]萍乡市人民医院重症医学科,江西省萍乡市337055

出　　处：《世界华人消化杂志》2022年第10期431-435,共5页World Chinese Journal of Digestology

基　　金：2020年江西省卫生健康委科技计划,No.20204373.

摘　　要：背景重症急性胰腺炎病情进展快,病死率高,如何延缓其病情进展及改善其预后,是当前医疗的一大难题;近年来,多项发现幽门螺杆菌(Helicobacter pylori,H.pylori)感染会影响急性胰腺炎的发生及发展;然而,它是否影响重症急性胰腺炎患者的预后,目前研究尚少.目的探讨H.pylori幽门螺杆菌感染对重症急性胰腺炎患者预后的影响.方法通过检测重症急性胰腺炎患者粪便H.pylori抗原,将患者分为H.pylori感染组(A组)及无H.pylori感染组(B组),分别记录并比较两组患者之间在入院时、入院后96 h、入院后2 wk急性生理与慢性健康评分Ⅱ(acute physiology and chronic health evaluationⅡ,APACHEⅡ)、急性胰腺炎严重程度床边指标(bedside index for severity in acute pancreatitis,BISAP)评分、改良CT严重指数(modified CT severity index,MCTSI)之间的差异,比较两组患者胰腺感染发生率、重症监护室(intensive care unit,ICU)住院时间、总住院时间、死亡率之间的差异.结果A组较B组入院后2 wk APACHEⅡ评分、BISAP评分、MCTSI评分均较高;A组患者ICU住院时间、总住院时间较B组显著长.结论H.pylori感染可能是导致重症胰腺炎病情进展的因素之一.BACKGROUND Severe acute pancreatitis progresses rapidly and has a high fatality rate.How to delay its progression and improve its prognosis is a major medical problem at present.In recent years,a number of studies have found that Helicobacter pylori(H.pylori)infection affects the occurrence and development of acute pancreatitis,but there are still few studies on whether it affects the prognosis of patients with severe acute pancreatitis.AIM To investigate the effect of H.pylori infection on the prognosis of severe acute pancreatitis.METHODS Patients with severe acute pancreatitis were divided into either an H.pylori infection group(group A)or a no H.pylori infection group(group B)according to the presence of H.pylori antigen or not.Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ),bedside index for severity in acute pancreatitis(BISAP),and modified CT severity index(MCTSI)were recorded and compared between the two groups at admission,96 h after admission,and 2 wk after admission.The incidence of pancreatic infection,length of intensive care unit(ICU)stay,and total length of stay were also compared between the two groups.RESULTS APACHEⅡ,BISAP,and MCTSI scores were higher in group A than in group B at 2 wk after admission.ICU stay and total length of stay in group A were significantly longer than those in group B.CONCLUSION H.pylori infection may be one of the factors leading to the progression of severe acute pancreatitis.

关 键 词：幽门螺杆菌 重症急性胰腺炎 预后 

分 类 号：R576[医药卫生—消化系统]