血液滤过治疗高脂血症重症急性胰腺炎的临床疗效分析  

Clinical effect of hemofiltration on hyperlipidemia-induced severe acute pancreatitis

作　　者：魏洪吉[1] WEI Hong-ji(Department of Pancreatic Hernia Surgery,Tai'an Central Hospital,Tai'an 271000,China)

机构地区：[1]山东省泰安市中心医院胰腺疝外科,271000

出　　处：《中国现代药物应用》2023年第11期27-31,共5页Chinese Journal of Modern Drug Application

摘　　要：目的 观察血液滤过治疗高脂血症重症急性胰腺炎(HL-SAP)的效果。方法 80例HL-SAP患者,依据随机数字表法分为A组和B组,每组40例。A组患者给予常规对症干预治疗,B组患者在A组基础上给予血液滤过治疗。对比两组患者不同时间点生化指标[甘油三酯(TG)、血淀粉酶(AMS)、尿AMS]水平,不同时间点炎性因子指标[C反应蛋白(CRP)、前白蛋白、肿瘤坏死因子-α(TNF-α)]水平,不同时间点全身炎症反应综合征(SIRS)评分、急性生理功能和慢性健康状况评估系统Ⅱ(APACHE Ⅱ)评分、Ranson评分,治疗后并发症发生情况及死亡情况。结果 治疗前,两组患者的TG、血AMS、尿AMS水平对比差异无统计学意义(P>0.05);治疗第2、7天,两组患者的TG、血AMS、尿AMS水平均低于本组治疗前,B组患者的TG、血AMS、尿AMS水平均低于A组,差异具有统计学意义(P<0.05)。治疗前,两组患者的CRP、前白蛋白、TNF-α水平对比差异无统计学意义(P>0.05);治疗第2、7天,两组患者的CRP、TNF-α水平均低于本组治疗前,前白蛋白水平均高于本组治疗前,B组患者的CRP、TNF-α水平均低于A组,前白蛋白水平均高于A组,差异具有统计学意义(P<0.05)。治疗前,两组患者的SIRS评分、APACHE Ⅱ评分、Ranson评分对比差异无统计学意义(P>0.05);治疗第2天,两组患者的SIRS评分、APACHE Ⅱ评分、Ranson评分均低于本组治疗前,B组患者的SIRS评分(1.90±0.29)分、APACHE Ⅱ评分(7.16±2.47)分、Ranson评分(2.29±1.19)分均低于A组的(2.33±0.36)、(11.25±2.58)、(3.08±1.21)分,差异具有统计学意义(P<0.05);治疗第7天,两组患者的SIRS评分、APACHE Ⅱ评分均低于本组治疗前,B组患者的SIRS评分(1.37±0.26)分、APACHE Ⅱ评分(6.10±2.39)分均低于A组的(1.98±0.29)、(10.10±2.39)分,差异具有统计学意义(P<0.05)。B组患者治疗后并发症发生率为7.50%,死亡率为0,均显著低于A组的25.00%、10.00%,差异具有统计学意义(P<0.05)。结Objective To observe the effect of hemofiltration on hyperlipidemia-induced severe acute pancreatitis(HL-SAP).Methods A total of 80 patients with HL-SAP were divided into group A and group B according to the random numerical table,with 40 patients in each group.Patients in group A received conventional symptomatic intervention treatment,and patients in group B received hemofiltration treatment on the basis of group A.Both groups were compared in terms of biochemical indexes[triglyceride(TG),blood amylase(AMS),urinary AMS]levels and inflammatory factor indexes[C-reactive protein(CRP),prealbumin,tumor necrosis factor-α(TNF-α)]levels at different time points,systemic inflammatory response syndrome(SIRS)score,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score and Ranson score at different time points,occurrence of complications after treatment,and mortality.Results Before treatment,there was no statistically significant difference in the levels of TG,blood AMS and urinary AMS between the two groups(P>0.05).On days 2 and 7 of treatment,the levels of TG,blood AMS and urinary AMS in the two groups were lower than those before treatment in this group,and the levels of TG,blood AMS and urinary AMS in group B were lower than those in group A.The differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in the levels of CRP,prealbumin and TNF-αbetween the two groups(P>0.05).On days 2 and 7 of treatment,the levels of CRP and TNF-αin the two groups were lower than those before treatment in this group,and the prealbumin level was higher than that before treatment in this group;the levels of CRP and TNF-α in group B were lower than those in group A, and the pre-albumin level was higher than that in group A;the differences were statistically significant (P<0.05). Before treatment, there was no statistically significant difference in SIRS score, APACHEⅡ score and Ranson score between the two groups (P>0.05). On day 2 of treatment, SIRS score, APACHE

关 键 词：血液滤过 高脂血症重症急性胰腺炎 甘油三酯 

分 类 号：R576[医药卫生—消化系统]