复发性急性胰腺炎的临床特征及危险因素分析  

Clinical features and risk factors of recurrent acute pancreatitis

作　　者：彭莉 麦刚[1] 刘航[1] 李雨[1] 史孝敏 彭燕 Peng Li;Mai Gang;Liu Hang;LI Yu;Shi Xiaomin;Peng Yan(Center for the Diagnosis and Treatment of Acute Pancreatitis,Deyang People′s Hospital,Deyang 618000,China;Department of Gastroenterology,Affiliated Hospital of Southwest Medical University,Luzhou 646000,China)

机构地区：[1]德阳市人民医院急性胰腺炎诊治中心,德阳618000 [2]西南医科大学附属医院消化内科,泸州646000

出　　处：《中华胰腺病杂志》2023年第4期278-282,共5页Chinese Journal of Pancreatology

摘　　要：目的探讨复发性急性胰腺炎(RAP)的临床特征,并分析与RAP相关的危险因素。方法回顾性分析2013年1月至2019年12月间西南医科大学附属医院AP数据库的3022例AP患者的临床资料,根据AP是否复发及RAP诊断标准将患者分为初发组(2187例)和复发组(835例),比较两组患者的一般特征、临床资料、临床转归,采用多因素logistic回归分析RAP的危险因素。结果复发组男性占比,既往合并胆道疾病、高脂血症、糖尿病及既往已行胆囊或胆道手术占比均显著高于初发组,而平均年龄明显低于初发组。初发组主要病因依次为胆道疾病、高脂血症、酒精,复发组依次为高脂血症、胆道疾病和酒精,复发组高脂血症病因显著高于初发组。复发组MAP发生率、区域性门静脉高压发生率显著高于初发组,而SAP发生率、急性呼吸窘迫综合征发生率显著低于初发组。以上差异均有统计学意义(P值均<0.05)。相关分析结果显示,RAP病情的严重程度与复发次数无相关性,RAP发生SAP的风险并未随复发次数的增加而降低。多因素logistic回归分析结果显示,既往有胆道疾病(OR=1.303,95%CI 1.032~1.645)、高脂血症(OR=2.631,95%CI 1.580~4.379,P<0.001)病史,病因为高脂血症(OR=1.773,95%CI 1.465~2.145)是RAP的独立危险因素。结论RAP好发于中年男性,高脂血症是RAP主要病因;既往有高脂血症、胆道疾病病史是RAP的危险因素。Objective To explore the clinical characteristics and to analyze the risk factors of recurrent acute pancreatitis(RAP).Methods The clinical data of 3022 patients with AP from AP database of the Affiliated Hospital of Southwest Medical University between January 2013 and December 2019 were retrospectively analyzed.According to with or without AP relapse and RAP diagnostic criteria,the patients were divided into initial group(n=2187)and recurrent group(n=835).General characteristics,clinical data,and prognostic indicators were compared between the two groups.Multivariate logistic regression analysis was used to explore the risk factors of RAP.Results The proportion of men,previous biliary disease,hyperlipidemia,diabetes mellitus and previous gallbladder or biliary surgery in recurrent group were significantly higher,while the mean age was significantly lower than that of the initial group.The main causes in the initial group successively were biliary disorders,hyperlipidemia and alcohol,while in the recurrent group were hyperlipidemia,biliary disorders and alcohol.The etiology of hyperlipidemia was significantly higher in the recurrent group than in initial group.The incidence of MAP and regional portal hypertension was significantly higher in the recurrent group,while the incidence of SAP and acute respiratory distress syndrome were significantly lower than those in the initial group,and all the differences were statistically significant(All P value<0.001).The results of the correlation analysis showed that there was no correlation between the severity of RAP and the number of recurrence,and the risk of SAP in RAP did not decrease with the increasing number of recurrence.The results of the multivariate logistic regression analysis showed that previous biliary disorders(OR=1.303,95%CI 1.032-1.645,P=0.026),previous history of hyperlipidemia(OR=2.631,95%CI 1.580-4.379,P<0.001),and the etiology of hyperlipidemia(OR=1.773,95%CI 1.465-2.145,P<0.001)were independent risk factors for RAP.Conclusions RAP may often occur in

关 键 词：复发性急性胰腺炎 危险因素 临床特征 区域性门脉高压 

分 类 号：R576[医药卫生—消化系统]