双重血浆置换在高脂血症性急性胰腺炎中的治疗效果  

Therapeutic effect of double filtration plasmapheresis in hyperlipidemic acute pancreatitis

作　　者：华天凤[1] 黄丽莎 肖文艳 张金 李惠[1] 郑瑶[1] 胡娟娟 陈虎[2] 储玉倩 张亮亮 杨旻[1] HUA Tianfeng;HUANG Lisha;XIAO Wenyan;ZHANG Jin;LI Hui;ZHENG Yao;HU Juanjuan;CHEN Hu;CHU Yuqian;ZHANG Liangliang;YANG Min(The Second Department of Critical Care Medicine,Laboratory of Cardiopulmonary Resuscitation and Critical Illness,The Second Affiliated Hospital of Anhui Medical University,Hefei,230601,China;The First Department of Critical Care Medicine,The Second Affiliated Hospital of Anhui Medical University)

机构地区：[1]安徽医科大学第二附属医院重症医学二科心肺复苏与危重病实验室,合肥230601 [2]安徽医科大学第二附属医院重症医学一科

出　　处：《临床急诊杂志》2023年第8期394-398,共5页Journal of Clinical Emergency

基　　金：2020年国家自然科学基金面上项目(No:82072134);安徽医科大学基础与临床合作研究提升计划项目(No:2019xkjT028);2020年国家自然科学基金孵育计划项目(No:2020GMFY05);安徽省教育厅2020年度高校优秀拔尖人才培养资助项目(No:gxyq2020007);学科建设经费(No:9101001821);2021年高峰学科建设经费(No:9101001804)。

摘　　要：目的探究双重血浆置换(double filtration plasmapheresis,DFPP)在高脂血症性急性胰腺炎(hypertriglyceridemia acute pancreatitis,HTG-AP)的治疗中的临床效果。方法纳入2016年1月-2022年11月入住安徽医科大学第二附属医院重症医学科的HTG-AP患者共33例。其中常规治疗23例为对照组,DFPP治疗10例作为试验组。记录和比较治疗前后两组中甘油三酯(triglyceride,TG)、总胆固醇(cholesterol,CHO)、高敏C反应蛋白(hypersensitive C-reactive protein,hsCRP)及白细胞(white blood cell,WBC)计数、白蛋白及纤维蛋白原以及预后指标(SOFA评分及APACHEⅡ评分)的变化,以此来分析及比较HTG-AP患者中使用DFPP的治疗效果。结果试验组及对照组在性别、生活习惯、胰腺炎分级、Rason评分等方面进行比较,差异无统计学意义(P>0.05)。DFPP可降低血脂(TG和CHO)、炎症相关因子及细胞(WBC及hsCRP)以及改善预后(SOFA评分及APACHEⅡ评分),TG、hsCRP,SOFA及APACHEⅡ评分降低幅度均高于对照组,两组差异有统计学意义(P<0.05)。结论DFPP能更加快速并有效地清除过高的血脂和降低炎症相关因子,有利于改善患者的预后,值得临床推广。Objective To investigate the clinical therapeutic effect of double filtration plasmapheresis(DFPP)in the treatment of acute hyperlipidemic pancreatitis(HTG-AP).Methods We included 33 cases of HTG-AP who were admitted to the Second Hospital of Anhui Medical University from January 2016 to November 2022.Among them,23 patients were treated with routine therapy as the control group,and 10 patients were treated with DFPP as the experimental group.The changes of the triglyceride(TG),total cholesterol(CHO),hypersensitive C-reactive protein(hsCRP),white blood cell(WBC),albumin,fibrinogen and prognostic index(SOFA score and APACHEⅡscore)before and after treatment were recorded and compared to explore the clinical efficacy of DFPP.Results There were no significant differences in gender,lifestyle habits,pancreatitis grade,and Ranson score between the two groups(P>0.05).DFPP can reduce blood lipid(TG and CHO),inflammatory factors(WBC and hsCRP)and improve the prognosis of patients(SOFA score and APACHEⅡscore),and there was no statistical difference in the changes of fibrinogen and albumin before and after treatment.The decreases of TG,hsCRP,SOFA score and APACHEⅡscore were higher than those of the control group,and the differences were statistically significant(P<0.05).Conclusion DFPP can more quickly and effectively eliminate excessive blood lipids and reduce inflammation-related factors and improve prognosis which is worthy to promote in clinical.

关 键 词：双重血浆置换 高脂血症性 急性胰腺炎 血脂 炎症 

分 类 号：R589.2[医药卫生—内分泌]