高脂血症性和胆源性重症急性胰腺炎临床特点及预后对比分析  

Comparative analysis of clinical characteristics and prognosis of hyperlipidemic and biliary severe acute pancreatitis

作　　者：黄睿 廖静 张怀蓉 邵艳霞 王钰姝 蒋春梅 肖伟 聂旭彪 曾冬梅 HUANG Rui;LIAO Jing;ZHANG Huairong;SHAO Yanxia;WANG Yushu;JIANG Chunmei;XIAO Wei;NIE Xubiao;ZENG Dongmei(Department of Emergency Medicine,the First Affiliated Hospital of Army Medical University,Chongqing 400038,China;Department of Gastroenterology,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China;Department of Gastroenterology,the Second Affiliated Hospital of Army Medical University,Chongqing 400037,China)

机构地区：[1]陆军军医大学第一附属医院急诊医学科,重庆400038 [2]重庆医科大学附属第二医院消化科,重庆400010 [3]陆军军医大学第二附属医院消化科,重庆400037

出　　处：《检验医学与临床》2024年第18期2633-2636,共4页Laboratory Medicine and Clinic

基　　金：重庆市科卫联合医学科研项目(2020FYYX071)。

摘　　要：目的分析高脂血症性重症急性胰腺炎(HLSAP)和胆源性重症急性胰腺炎(BSAP)的临床特点及预后情况。方法回顾性选取2020年5月至2023年5月陆军军医大学第一附属医院急诊医学科、重庆医科大学附属第二医院消化科、陆军军医大学第二附属医院消化科收治的258例SAP患者作为研究对象,并按照疾病类型将患者分为HLSAP组(159例)和BSAP组(99例)。收集所有患者的临床资料,包括年龄、性别、预后情况、总住院时间、ICU住院时间、呼吸机使用时间、连续性肾脏替代治疗(CRRT)时间、禁食时间、甘油三酯、血淀粉酶、血脂肪酶、D-二聚体、血糖水平。结果BSAP组年龄大于HLSAP组,差异有统计学意义(P<0.05)。HLSAP组康复患者比例高于BSAP组,好转、转为慢性患者比例低于BSAP组,差异均有统计学意义(P<0.05)。HLSAP组血糖、甘油三酯、D-二聚体水平高于BSAP组,差异均有统计学意义(P<0.05)。HLSAP组禁食时间短于BSAP组,差异有统计学意义(P<0.05)。HLSAP组死亡患者的年龄段以40~<50岁的中青年群体为主,BSAP组以>50岁的中老年群体为主。两组死亡患者的年龄段分布情况比较,差异有统计学意义(P<0.05)。结论对比HLSAP和BSAP的临床特点,可帮助临床更好地识别两种类型SAP,及时给予精细化、规范化治疗,降低病死率,减少住院时间。Objective To analyze the clinical characteristics and prognosis of hyperlipidemic severe acute pancreatitis(HLSAP)and biliary severe acute pancreatitis(BSAP).Methods A total of 258 severe acute pancreatitis(SAP)patients admitted in the First Affiliated Hospital of Army Medical University,the Second Affiliated Hospital of Chongqing Medical University and the Second Affiliated Hospital of Army Medical University from May 2020 to May 2023 were retrospectively selected as the research subjects.According to the type of disease,the patients were divided into HLSAP group(159 cases)and BSAP group(99 cases).The clinical data including age,gender,prognosis,total length of hospital stay,length of ICU stay,ventilator use time,continuous renal replacement therapy(CRRT)time,fasting time,triglyceride,blood amylase,blood lipase,D-dimer,blood glucose levels were collected.Results The age of BSAP group was higher than that of HLSAP group,and the difference was statistically significant(P<0.05).The proportion of rehabilitation patients in HLSAP group was higher than that in BSAP group,and the proportion of patients with improvement and chronic disease in HLSAP group was lower than that in BSAP group,with statistical significance(P<0.05).The levels of blood glucose,triglyceride and D-dimer were higher than those in BSAP group,with statistical significance(P<0.05).The fasting time of HLSAP group was shorter than that of BSAP group,and the difference was statistically significant(P<0.05).The age of dead patients in HLSAP group was mainly middle-aged and young people aged 40-<50 years,and the age of dead patients in BSAP group was mainly middle-aged and elderly people aged>50 years.There was a statistically significant difference in the age distribution of death patients between the two groups(P<0.05).Conclusion Comparing the clinical characteristics of HLSAP and BSAP can help the clinic to better identify the two types of SAP,give refined and standardized treatment in time,reduce the fatality rate and reduce the length of hospital sta

关 键 词：胆源性重症急性胰腺炎 高脂血症性重症急性胰腺炎 血淀粉酶 甘油三酯 血脂肪酶 

分 类 号：R576[医药卫生—消化系统] R446.112[医药卫生—内科学]