中国近十年妊娠合并急性胰腺炎危险因素的Meta分析  

Meta-analysis of risk factors for acute pancreatitis in pregnancy in China in recent ten years

作　　者：熊玉玲 田月 李善 杨晶 高青[2] Xiong Yuling;Tian Yue;Li Shan;Yang Jing;Gao Qing(Department of Gastroenterology,Fengdu County People′s Hospital of Chongqing,Chongqing 408200,China;Department of Gastroenterology,First Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆市丰都县人民医院消化内科,重庆408200 [2]重庆医科大学附属第一医院消化内科,重庆400010

出　　处：《中华胰腺病杂志》2022年第6期453-460,共8页Chinese Journal of Pancreatology

摘　　要：目的系统评价我国近10年妊娠合并急性胰腺炎(APIP)的危险因素。方法以急性胰腺炎、妊娠、危险因素、临床特征为检索词,计算机检索2011年12月至2021年12月PubMed、Cochrane Library、Embase、中国知网、万方、维普及中国生物医学文献数据库收录的关于我国APIP的病例对照研究。采用RevMan 5.4软件进行Meta分析。结果26篇文献共1525例APIP患者(重症645例,轻症880例)纳入研究。Meta分析结果显示,妊娠早期、妊娠晚期、高脂血症性、胆源性是APIP的危险因素。妊娠早期重症组患者占4.22%,轻症组占10.43%;妊娠晚期重症组患者占81.95%,轻症组占69.72%。高脂血症性病因在重症组占52.16%,轻症组占22.69%;胆源性病因在重症组占27.96%,轻症组占41.71%,上述指标组间差异均有统计学意义(P值均<0.05)。重症患者的发病年龄、体重指数及血清C反应蛋白、三酰甘油水平高于轻症患者,与APIP的病情严重程度呈正相关(MD值分别为0.99、1.33、65.97、6.44;95%CI分别为0.03~1.96、0.59~2.08、23.43~108.50、4.49~8.39;P值分别为0.04、0.0005、0.002、<0.001),而血钙、血清白蛋白水平低于轻症患者,与APIP的病情严重程度呈负相关(MD值分别为-0.37、-5.93;95%CI分别为-0.50~-0.24、-9.11~-2.75,P值分别为<0.001、0.003)。结论急性胰腺炎可于妊娠期的各个阶段发生,早期妊娠以轻症为主,晚期妊娠多见重症。我国高三酰甘油血症性胰腺炎病情进展快,更倾向于重症化。Objective To systematically assess the risk factors for acute pancreatitis in pregnancy(APIP)in China in recent 10 years.Methods Acute pancreatitis,pregnancy,risk factors and clinical features were used as search terms.Case-control studies on APIP in China were retrieved by computer from PubMed,Cochrane Library,Embase,CNKI,Wanfang,VIP and Chinese Biomedical Literature Database from December 2011 to December 2021.RevMan 5.4 software was utilized for Meta analysis.Results A total of 1525 APIP patients(645 severe cases and 880 mild cases)were included in 26 literatures.Meta analysis showed that early pregnancy,late pregnancy,hyperlipidemia and biliary etiology were the risk factors for APIP.In the early pregnancy,4.22%of patients were in the severe group and 10.43%were in the mild group;In the late pregnancy,81.95%of the patients were in the severe group and 69.72%were in the mild group.The causes of hyperlipidemia accounted for 52.16%in the severe group and 22.69%in the mild group.The causes of biliary disease accounted for 27.96%in the severe group and 41.71%in the mild group.All the differences of the above indicators between groups were statistically significant(all P value<0.05).The age at onset,body mass index,serum C-reactive protein and triacylglycerol levels of severe patients were higher than those of mild patients,and were positively correlated with the severity of APIP(MD values were 0.99,65.97,1.33,6.44,95%CI values were 0.03-1.96,0.59-2.08,23.43-108.50,4.49-8.39,P values were 0.04,0.0005,0.002,<0.001).The levels of blood calcium and serum albumin were lower than those of mild patients,and were negatively correlated with the severity of APIP(MD values were-0.37,-5.93,95%CI values were-0.50--0.24,-9.11--2.75,P values were<0.001,0.003).Conclusions Acute pancreatitis can occur in all stages of pregnancy.Early pregnancy is mainly mild,and severe cases are more common in late pregnancy.Hypertriglyceridemic pancreatitis progresses rapidly,and tends to become more severe in China.

关 键 词：胰腺炎 妊娠 危险因素 META分析 

分 类 号：R576[医药卫生—消化系统]