不同病因妊娠合并急性胰腺炎患者的临床特征及母婴预后研究  

Analysis of Clinical Characteristics and Maternal and Neonatal Outcomes in Pregnancy Complicated with Acute Pancreatitis Patients of Different Etiologies

作　　者：徐俊 齐文杰[1] 王超[1] 胡岚[1] 苗彬[1] XU Jun;QI Wenjie;WANG Chao;HU Lan;MIAO Bin(Department of Infection,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感染内科,北京市100050

出　　处：《中国全科医学》2024年第11期1343-1348,共6页Chinese General Practice

基　　金：国家自然科学基金资助项目(82274259)。

摘　　要：背景由于经济发展及国内生育政策改变,妊娠合并急性胰腺炎(APIP)发病率逐渐增加,不同病因的APIP临床特点不同,且对母婴预后的影响可能存在较大差异,既往对此研究较少。目的分析不同病因APIP的临床特征及其与母婴预后的关系。方法收集2016—2022年首都医科大学附属北京友谊医院收治的48例住院APIP患者的临床资料,根据病因分为胆源性组(n=27)及高脂血症组(n=21),对比分析两组实验室检查指标以及母婴结局。结果胆源性组起病至就诊时间长于高脂血症组,入院时孕周短于高脂血症组,既往孕次多于高脂血症组,腹泻及停止排便所占比例低于高脂血症组(P<0.05)。两组患者严重程度比较,差异无统计学意义(P=0.912)。胆源性组血红蛋白、血小板计数、C反应蛋白、胆固醇、三酰甘油水平低于高脂血症组,总胆红素、直接胆红素、丙氨酸氨基转移酶、碱性磷酸酶、谷氨酰转肽酶、血肌酐、血钙、血钠、血淀粉酶、N末端脑钠肽前体水平高于高脂血症组(P<0.05)。胆源性组分娩时孕周短于高脂血症组(P<0.05)。胆源性组和高脂血症组早产率、剖宫产率、剖宫产人为干预终止妊娠率比较,差异均无统计学意义(P>0.05)。胆源性组新生儿重量小于高脂血症组,身长短于高脂血症组,病理性黄疸、呼吸窘迫、呼吸机辅助呼吸发生率高于高脂血症组(P<0.05)。结论胆源性疾病目前仍为APIP患者的第一位病因,可显著缩短母体的分娩孕周,并造成胎儿低体质量,增加胎儿病理性黄疸、呼吸窘迫、呼吸机辅助呼吸的发生率,引起胎儿更为严重的预后。Background Due to economic development changes in domestic fertility policy,the incidence of acute pancreatitis in pregnancy(APIP)has been gradually increasing.The clinical characteristics of APIP of different etiologies are different,and there may be significant differences in the prognosis for mothers and infants,but previous studies on this are relatively few.Objective To analyze the clinical characteristics and maternal and neonatal outcomes in pregnancy complicated with acute pancreatitis patients of different etiologies.Methods A total of 48 inpatients with APIP in Beijing Friendship Hospital,Capital Medical University from 2016 to 2022 were collected,which were divided into the biliary group(n=27)and hyperlipidemic group(n=21).The laboratory indicators and maternal and infant outcomes in the two groups were compared.Results The biliary group had a longer time of onset to visit,a smaller gestational week at admission,more previous pregnancies,and lower percentage of diarrhea and cessation of defecation than the hyperlipidemic group(P<0.05).There was no statistically significant difference in severity between the two groups of patients(P=0.912).The levels of hemoglobin,platelets,C-reactive protein,cholesterol,and triacylglycerol in the biliary group were lower than those in the hyperlipidemia group,while the levels of total bilirubin,direct bilirubin,alanine transaminase,alkaline phosphatase,glutamyltranspeptidase,creatinine,calcium,sodium,amylase,and N-terminal brain natriuretic peptide precursor were higher than those in the hyperlipidemia group(P<0.05).The gestational week at delivery of the biliary group was shorter than the hyperlipidemia group(P<0.05).There was no statistically significant difference in premature delivery rate,cesarean section rate,and artificial intervention termination of pregnancy rate between the biliary group and hyperlipidemia group(P>0.05).The birth weight of the biliary group was smaller than the hyperlipidemia group,while the birth length was shorter than the hyperlipidemia gr

关 键 词：急性胰腺炎 妊娠 妊娠合并急性胰腺炎 妇幼保健服务 预后 

分 类 号：R576[医药卫生—消化系统]