高甘油三酯血症性胰腺炎的临床特点以及甘油三酯水平与重症急性胰腺炎病情严重程度的相关性  

The clinical characteristics of hypertriglyceridemic pancreatitis and the correlation between triglyceride levels and the severity of severe acute pancreatitis

作　　者：孙晓萌[1] 王国兴[1] Sun Xiaomeng;Wang Guoxing(Department of Emergency,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院急诊科,北京100050

出　　处：《中国医师杂志》2023年第8期1209-1213,共5页Journal of Chinese Physician

基　　金：北京市医院管理中心临床医学发展专项——"扬帆"计划(ZYLX201802)。

摘　　要：目的探讨高甘油三酯血症性胰腺炎的临床特点以及甘油三酯(TG)水平与重症急性胰腺炎(SAP)病情严重程度的相关性。方法回顾性分析2020年1月至2021年12月首都医科大学附属北京友谊医院住院治疗的132例SAP患者的临床资料,根据其发病原因分为胆源性胰腺炎(BAP)组、高甘油三酯血症性胰腺炎(HTGP)组、酒精性胰腺炎(AAP)组,比较各组临床资料及实验室检查结果,分析TG水平与SAP疾病严重程度的相关性。结果HTGP组男性患者比例、体重指数、住院时间、ICU入住率及C-反应蛋白(CRP)、TG、总胆固醇(TC)水平明显高于BAP及AAP组,HTGP组患者发病年龄、血清钙离子(Ca)、氧合指标(P/F)及凝血酶原活动度(PTA)明显低于BAP及AAP组,差异均有统计学意义(均P<0.05)。TG水平与SAP患者Ca、P/F、PTA之间呈负相关(r=-0.410、-0.341、-0.365,均P<0.01)。ROC曲线分析显示,TG早期预测SAP患者合并多脏器功能损伤的曲线下面积(AUC)为0.868,灵敏度为87%,特异度为78%。结论HTGP组患者发病年龄更小,男性及肥胖患者、重症患者更多,实验室指标CRP、TG、TC水平更高,Ca、P/F及PTA水平更低;血清TG水平与SAP疾病严重程度相关,可作为早期预测SAP合并多脏器功能损伤的指标之一。Objective To explore the clinical characteristics of hypertriglyceridemic pancreatitis and the correlation between triglyceride(TG)levels and the severity of severe acute pancreatitis(SAP).Methods A retrospective analysis was conducted on the clinical data of 132 SAP patients admitted to Beijing Friendship Hospital of Capital Medical University from January 2020 to December 2021.They were divided into biliary acute pancreatitis(BAP)group,hypertriglyceridemic pancreatitis(HTGP)group,and alcohol-induced acute pancreatitis(AAP)group based on their etiology.The clinical data and laboratory test results of each group were compared,and the correlation between TG levels and the severity of SAP disease was analyzed.Results The proportion of male patients,body mass index,length of hospital stay,ICU occupancy rate,C-reactive protein(CRP),TG,and total cholesterol(TC)levels in the HTGP group were significantly higher than those in the BAP and AAP groups.The age of onset,serum calcium(Ca),oxygenation index(PaO2/FiO2,P/F),and prothrombin time activity(PTA)in the HTGP group were significantly lower than those in the BAP and AAP groups,and the differences were statistically significant(all P<0.05).There was a negative correlation between TG levels and Ca,P/F,PTA in SAP patients(r=-0.410,-0.341,-0.365,all P<0.01).Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)of TG for early prediction of multiple organ dysfunction in SAP patients was 0.868,with a sensitivity of 87%and a specificity of 78%.Conclusions Patients in the HTGP group have a lower onset age,with more males,obese patients,and critically ill patients.Laboratory indicators such as CRP,TG,and TC levels are higher,while levels of Ca,P/F,and PTA are lower;The serum TG level is correlated with the severity of SAP disease and can be used as one of the early indicators for predicting multiple organ dysfunction in SAP.

关 键 词：高甘油三酯血症 胰腺炎 

分 类 号：R576[医药卫生—消化系统]