首发和复发急性高甘油三酯血症胰腺炎临床特征比较的全国多中心临床研究  

Comparison of clinical characteristics between first‐episode and recurrent acute hypertrigly‐ceridemic pancreatitis:a national multicenter clinical research

作　　者：李帅 周晶 罗贵贤 张宏伟 刘斯瑶 姚维杰 洪东煌[6] 秦开秀[7] 王兰庭 韦蓉 徐怡禛 曹龙祥 童智慧 刘玉秀 李维勤 柯路 Li Shuai;Zhou Jing;Luo Guixian;Zhang Hongwei;Liu Siyao;Yao Weijie;Hong Donghuang;Qin Kaixiu;Wang Lanting;Wei Rong;Xu Yizhen;Cao Longxiang;Tong Zhihui;Liu Yuxiu;Li Weiqin;Ke Lu(Severe Pancreatitis Center,Nanjing Jinling Hospital,The Affiliated Hospital of Medical School of Nanjing University,Nanjing 210002,China;Department of Critical Care Medicine,People′s Hospital of Qianxinan Prefecture,Xingyi 562400,China;Department of Critical Care Medicine,Traditional Chinese Medicine Hospital of Jinjiang,Jinjiang 362200,China;Department of Emergency,The First Affiliated Hospital of Xiamen University,Xiamen 361003,China;Department of Hepatobiliary Surgery,General Hospital of Ningxia Medical University,Yinchuan 750004,China;Department of Critical Care Medicine,Fujian Provincial Hospital,Fuzhou 350001,China;Department of Emergency,The Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]南京大学医学院附属金陵医院重症胰腺炎中心,南京210002 [2]黔西南州人民医院重症医学科,兴义562400 [3]晋江市中医院重症医学科,晋江362200 [4]厦门大学附属第一医院急诊科,厦门361003 [5]宁夏医科大学总医院肝胆外科,银川750004 [6]福建省立医院重症医学科,福州350001 [7]重庆医科大学附属第二医院急救部,重庆400010

出　　处：《中华消化外科杂志》2024年第5期703-711,共9页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金(82070665)。

摘　　要：目的探讨首发和复发急性高甘油三酯血症胰腺炎(HTGP)的临床特征。方法采用回顾性队列研究方法。收集2020年11月至2021年12月中国急性胰腺炎临床研究小组(CAPCTG)‑PERFORM数据库中全国26家医学中心收治的313例HTGP患者的临床资料;男219例,女94例;年龄为38(32,44)岁。313例患者中,193例为首次发病,设为首发组;120例为复发,设为复发组。观察指标:(1)倾向评分匹配情况及匹配后两组患者一般资料比较。(2)两组患者病程14 d内严重程度及预后情况比较。(3)复发性HTGP与持续器官衰竭(POF)发生风险之间的关联。(4)随访情况。正态分布的计量资料以x±s表示,组间比较采用独立样本t检验。偏态分布的计量资料以M(Q1,Q3)表示,组间比较采用Wilcoxon秩和检验。计数资料以绝对数或百分比表示,组间比较采用χ^(2)检验。等级资料采用Wilcoxon秩和检验。采用Kaplan‑Meier法绘制累积复发发生率曲线,Log‑Rank检验进行生存分析。多因素分析采用Logistic回归模型,连续变量按照均值或公认标准转换为分类变量。倾向评分匹配按1∶1最近邻匹配法匹配,卡钳值为0.02。匹配后组间比较采用配对t检验或Wilcoxon秩和检验以及McNemar′s检验分析。结果(1)倾向评分匹配情况及匹配后两组患者一般资料比较。313例患者中,208例配对成功,首发组和复发组各104例。倾向评分匹配后,两组患者人口学特征、病情严重程度评分、实验室检查结果比较,差异均无统计学意义(P>0.05)。消除性别、急性生理与慢性健康Ⅱ评分、计算机断层扫描严重程度指数评分、全身性炎症反应综合征评分、序贯器官衰竭评分、载脂蛋白E、C反应蛋白、肌酐、乳酸脱氢酶、降钙素原、连续肾脏替代治疗因素混杂偏倚,具有可比性。(2)两组患者病程14 d内严重程度及预后情况比较。首发组患者POF和局部并发症与复发组比较,差异均有统计学�Objective To investigate the clinical characteristics of first-episode and recurrent acute hypertriglyceridemic pancreatitis(HTGP).Methods The retrospective cohort study was conducted.The clinical data of 313 patients with HTGP admitted to 26 medical centers in China in the Chinese Acute Pancreatitis Clinical Research Group(CAPCTG)-PERFORM database from November 2020 to December 2021 were collected.There were 219 males and 94 females,aged 38(32,44)years.Of the 313 patients,193 patients with first‐episode HTGP were allocated into the first‐episode group and 120 patients with recurrent HTGP were allocated into the recurrent group.Observation indicators:(1)propensity score matching and comparison of general data of patients between the two groups after matching;(2)comparison of severity and prognosis in the course of disease within 14 days between the two groups;(3)the association between recurrent HTGP and the risk of persistent organ failure(POF);(4)follow‐up.Measurement data with normal distribution were represented as Mean±SD,and comparison between groups was conducted using the independent sample t test.Measurement data with skewed distribution were represented as M(Q1,Q3),and comparison between groups was conducted using the Wilcoxon rank sum test.Count data were expressed as absolute numbers or percentages,and comparison between groups was conducted using the chi‐square test.Comparison of ordinal data was conducted using the Wilcoxon rank sum test.The Kaplan‐Meier method was used to plot the cumulative recurrence rate curve and Log‐Rank test was used for survival analysis.The Logistic regression model was used for multivariate analysis,and continuous variables were converted into categorical variables according to the mean value or common criteria.Propensity score matching was performed by 1∶1 nearest neighbor matching method,with caliper value of 0.02.Paired t test or Wilcoxon rank sum test and McNemar′s test were used for comparison between matched groups.Results(1)Propensity score matching

关 键 词：急性高甘油三酯血症胰腺炎 复发性急性胰腺炎 器官功能衰竭 预后 疗效 安全性 复发 

分 类 号：R589.2[医药卫生—内分泌] R576[医药卫生—内科学]