Incidence and clinical characteristics of hypertriglyceridemic acute pancreatitis:A retrospective single-center study  

作　　者：Xue-Yan Lin Yi Zeng Zheng-Chao Zhang Zhi-Hui Lin Lu-Chuan Chen Zai-Sheng Ye 

机构地区：[1]Department of Gastroenterology,Fujian Provincial Hospital,Fujian Medical University Provincial of Clinical Medicine,Fuzhou 350001,Fujian Province,China [2]Department of Gastrointestinal Surgical Oncology,Fujian Cancer Hospital,Fujian Medical University Cancer Hospital,Fuzhou 350014,Fujian Province,China [3]Department of Emergency Surgery,Fujian Provincial Hospital,Fujian Medical University Provincial of Clinical Medicine,Fuzhou 350001,Fujian Province,China

出　　处：《World Journal of Gastroenterology》2022年第29期3946-3959,共14页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND The incidence of hypertriglyceridemic acute pancreatitis(HTG-AP)has increased yearly,but updated population-based estimates on the incidence of HTG-AP are lacking.Reducing serum triglyceride(TG)levels quickly is crucial in the early treatment of HTG-AP.Decreased serum TG levels are treated by non-invasive methods,which include anti-lipidemic agents,heparin,low-molecular weight heparin,and insulin,and invasive methods,such as blood purification including hemoperfusion(HP),plasmapheresis,and continuous renal replacement therapy.However,authoritative guidelines have not been established.Early selection of appropriate treatment is important and beneficial in controlling the development of HTG-AP.AIM To evaluate the effect between patients treated with intravenous insulin(INS)and HP to guide clinical treatment.METHODS We retrospectively reviewed 371 patients with HTG-AP enrolled in the Department of Fujian Provincial Hospital form April 2012 to March 2021.The inpatient medical and radiologic records were reviewed to determine clinical features,severity,complications,mortality,recurrence rate,and treatment.Multivariate logistic regression analyses were used to analyze risk factors for severe HTG-AP.Propensity score matching was used to compare the clinical outcomes of INS and HP.RESULTS A total of 371 patients met the HTG-AP criteria.The incidence of HTG-AP was increased by approximately 2.6 times during the 10 years(8.4%in April 2012-March 2013 and 22.3%in April 2020-March 2021).The highest incidence rate of acute pancreatitis was observed for men in the age group of 30-39 years.The amylase level was elevated in 80.1%of patients but was only three times the normal value in 46.9%of patients.The frequency of severe acute pancreatitis(26.9%),organ failure(31.5%),rate of recurrence(32.9%),and mortality(3.0%)of HTG-AP was high.Improved Marshall score,modified computed tomography severity index score,baseline TG,baseline amylase,C-reactive protein(CRP),albumin,aspartate aminotransferase,low-density lipoprotein ch

关 键 词：Hypertriglyceridemic acute pancreatitis TRIGLYCERIDE Improved Marshall score Severity of acute pancreatitis Intravenous insulin HEMOPERFUSION 

分 类 号：R576[医药卫生—消化系统]