非胆源性急性胰腺炎严重程度早期预测因子及交互作用的影响  

Early predictors of severity and interaction of non-biliary acute pancreatitis

作　　者：李静 蒋淼 胡静娴 LI Jing;JIANG Miao;HUJingxian(Department of Gastroenterology,Jinshan Hospital,Fudan University,Shanghai 201500,China)

机构地区：[1]复旦大学附属金山医院消化内科,上海201500

出　　处：《实用医学杂志》2024年第12期1701-1705,共5页The Journal of Practical Medicine

基　　金：复旦大学附属金山医院科研项目(编号:JYQN-JC-202309);复旦大学附属金山医院人才队伍建设三年行动计划(2023-2031年)(编号:ZDXK-2023-7)。

摘　　要：目的探讨非胆源性急性胰腺炎相关检测指标对其严重程度的早期预测价值,以及相关检验指标的交互作用对非胆源性急性胰腺炎的影响。方法以2019年7月至2023年7月在复旦大学附属金山医院住院治疗的280例非胆源性急性胰腺炎首次发作患者为研究对象,将其分为轻度组和重度组,其中重度组包括中度重症、重症患者。收集首次发作住院患者入院48 h内的临床资料、检验及检查指标,通过logistic回归分析,探索与非胆源性急性胰腺炎严重度相关的早期检测指标,并研究其交互作用的影响。结果通过单因素分析发现,两组中的白蛋白(ALB)、甲状腺素(T4)、血清游离三碘甲腺原氨酸(FT3)、促甲状腺激素(TSH)、血清甘油三酯(TG)、钙(CA)等检测指标,差异具有统计学意义(P<0.05);通过多因素logistic回归分析发现,T4、FT3、TSH、CA等检测指标的OR值均小于1(P<0.05);在控制性别、年龄、高血压病史、糖尿病史等因素情况下,分析TG与HbA1c间的交互作用发现,仅HbA1c升高时的aOR为1.500(P>0.05),仅TG升高的aOR为4.488(P<0.05),TG和HbA1c同时升高时的aOR为5.084(P<0.05)。结论ALB、T4、FT3、TSH、CA为非胆源性AP的保护因素,可作为非胆源性急性胰腺炎严重程度的预测指标;HbA1c与TG的交互作用增加了非胆源性急性胰腺炎进展为重症的风险。Objective To explore the early prediction value of related test indicators for non-biliary acute pancreatitis and the influence of interaction of related test indicators on non-biliary acute pancreatitis.Methods A total of 280 patients with the first onset of non-biliary acute pancreatitis who were hospitalized in Jinshan Hospital of Fudan University from July 2019 to July 2023 were divided into mild group and severe group.The severe group included moderately severe and severe patients.Clinical data,tests and examination indicators of first-attack inpatients within 48 hours after admission were collected.Through logistics regression analysis,early detection indicators related to the severity of non-biliary acute pancreatitis were explored,and the influence of their interaction was studied.Results Single-factor analysis showed that albumin(ALB),thyroxine(T4),serum free triiodothyronine,albumin(ALB),Thyroxine(T4)in both groups.(FT3),thyroid stimulating hormone(TSH),serum triglyceride(TG),calcium(Ca)and other indicators were statistically significant(P<0.05);Through multi-factor logistics regression analysis,it was found that the OR values of T4,FT3,TSH,CA and other detection indicators were all less than 1(P<0.05);After controlling for gender,age,history of hypertension,history of diabetes and other factors,the interaction between TG and HbA1c was analyzed,the aOR was 1.500 when only HbA1c was increased(P>0.05),the aOR was 4.488 when only TG was increased(P<0.05),and the aOR was 5.084 when TG and HbA1c were increased simultaneously(P<0.05).Conclusion ALB,T4,FT3,TSH,CA were protective factors of non-biliary AP,and could be used as predictive indicators of the severity of non-biliary acute pancreatitis.Interaction of HbA1c with TG increases the risk of progression to severe non-biliary acute pancreatitis.

关 键 词：非胆源性 急性胰腺炎 严重程度 早期预测 交互作用 

分 类 号：R576[医药卫生—消化系统]