急性胰腺炎伴代谢综合征的临床特点和危险因素分析  

Analysis of clinical features and risk factors of acute pancreatitis with metabolic syndrome

作　　者：赵永红 陈爱荣[1] 胡梦茹 王燚鑫 衣桂荣 ZHAO Yong-hong;CHEN Ai-rong;HU Meng-ru;WANG Yi-xin;YI Gui-rong(Department of Endocrinology and Metabolism,Second Hospital of Lanzhou University,Lanzhou 730000,China;Department of Gastroenterology,Second Hospital of Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第二医院内分泌与代谢病科,730000 [2]兰州大学第二医院消化内科,730000

出　　处：《现代消化及介入诊疗》2024年第6期664-669,共6页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：甘肃省自然科学基金(22JR11RA068);甘肃省科技计划项目(2023-1-1)。

摘　　要：目的探究急性胰腺炎(Acute pancreatitis,AP)合并代谢综合征(metabolic syndrome,MS)的临床特征及危险因素。方法回顾性选取2019年9月至2023年9月在兰州大学第二医院内分泌与代谢病科和消化内科就诊的诊断为AP的139例患者,将其分为MS组76例,非MS组63例,收集并分析2组一般资料;给予2组患者保守治疗,分别对两组的一般情况、实验室指标、合并症、病情严重程度相关指标进行比较分析,对患者(AP合并MS)预后不良的影响因素进行分析。结果与非MS组患者比较,MS组HDL、Ca 2+显著下降,体重、体重质量指数(BMI)、糖尿病、高血压(收缩压/舒张压)、高脂血症、白细胞计数、CRP、PCT、IL-6、FPG、UA、TC、TG、TyG、TyG-BMI及非传统血脂参数TC/HDL-C、TG/HDL-C、LDL-C/HDL-C、非HDL-C显著升高,2组年龄、性别、住院时长、BUN、CREA、LDL-C、ALT、AST比较无明显差异(P>0.05);BMI、白细胞计数、CRP、IL-6、FPG、UA、TC、TG、TyG、TyG-BMI、TC/HDL-C、TG/HDL-C、LDL-C/HDL-C、非HDL-C是AP合并MS患者预后不良的独立危险因素,HDL-C是AP合并MS病人预后的潜在保护因素,差异有统计学意义(P<0.05)。结论随着现代生活方式的改变,MS患者越来越多,MS合并AP患者的发病率也逐渐增高,TyG、TyG-BMI指数和非传统血脂参数是一种新颖且临床方便、实用的评估的标志物,其对AP伴发MS代谢异常有较高的诊断及预测价值,为管理和干预提供临床依据。Objective To investigate the clinical features and prognosis of acute pancreatitis(AP)complicated with metabolic syndrome(MS).Methods 139 AP patients were retrospectively selected and divided into MS group(76 cases)and non-MS group(63 cases),general data of the two groups were collected and analyzed;conservative treatment was given to 2 groups of patients,and the general conditions,laboratory indicators,comorbidities,and related indicators of disease severity of the two groups were compared and analyzed,and the influencing factors of poor prognosis in patients(AP combined with MS)were analyzed.Results Compared with non-MS group,HDL,Ca 2+in MS group decreased significantly,Body weight、Body Mass Index(BMI)、diabetes mellitus、hypertension(systolic/diastolic blood pressure)、hyperlipidemia、white blood cell count、CRP、PCT、IL-6、FPG、UA、TC、TG、TyG、TYG-BMI and non-traditional lipid parameters TC/HDL-C、TG/HDL-C、LDL-C/HDL-C and non-HDL-C were significantly increased.There were no significant differences in age、sex、length of stay、BUN、CREA、LDL-C、ALT and AST between the two groups(P>0.05);BMI,white blood cell count,CRP,IL-6,FPG,UA,TC,TG,TyG,TYG-BMI,TC/HDL-C,TG/HDL-C,LDL-C/HDL-C,and non-HDL-C were independent risk factors for poor prognosis in AP patients with MS,and HDL-C was a potential protective factor for prognosis in AP patients with MS,the difference was statistically significant(P<0.05).Conclusion With the change of modern lifestyle,there are more and more MS patients,and the incidence of MS patients with AP is gradually increasing.TyG,TYG-BMI and non-traditional lipid parameters are novel,convenient and practical markers for clinical evaluation,which have a high diagnostic and predictive value for AP with MS metabolic abnormalities,and provides clinical basis for management and intervention.

关 键 词：急性胰腺炎 代谢综合征 临床特点 预后 TyG TyG-BMI HDL-C 

分 类 号：R576[医药卫生—消化系统]