血清甘油三酯累积暴露水平对急性胰腺炎发病风险的影响  

Influence of serum cumulative triglyceride exposure on the risk of acute pancreatitis

作　　者：苏阿芳 蒋晓忠[1] 张云水 吴寿岭[2] 李广鉴[1] SU Afang;JIANG Xiaozhong;ZHANG Yunshui;WU Shouling;LI Guangjian(Department of Gastroenterology,Kailuan General Hospital,Tangshan,Hebei 063000,China;Department of Cardiology,Kailuan General Hospital,Tangshan,Hebei 063000,China;Department of Critical Care Medicine,Air Force Medical Center,Air Force Medical University,Beijing 100142,China)

机构地区：[1]开滦总医院消化内科,河北唐山063000 [2]开滦总医院心内科,河北唐山063000 [3]空军军医大学空军特色医学中心重症医学科,北京100142

出　　处：《临床肝胆病杂志》2024年第12期2492-2498,共7页Journal of Clinical Hepatology

基　　金：河北省卫生健康委专项科研基金项目(20221582)。

摘　　要：目的探讨甘油三酯累积暴露(cumTG)与急性胰腺炎(AP)发病风险的关联。方法采用前瞻性队列研究方法,以连续参加2006—2010年度(2006、2008、2010年度)三次健康体检、既往无AP病史且TG资料完整的开滦职工56883例为观察队列。根据计算的cumTG值按四分位数分为4组(Q1、Q2、Q3、Q4组),对组间一般资料进行比较。正态分布的计量资料多组间比较采用单因素方差分析;偏态分布计量资料多组间比较采用Kruskal-Wallis H检验。计数资料组间比较采用χ^(2)检验。经Kaplan-Meier法绘制生存曲线并计算AP的累积发病率,用Log-rank法进行检验,采用Cox回归模型分析不同cumTG分组对新发AP事件的影响。结果随访(10.51±1.76)年,共发生AP事件158例,总发病密度为2.64/万人年;Q1、Q2、Q3、Q4组的发病例数及发病密度分别为29例(1.93/万人年)、34例(2.27/万人年)、30例(2.01/万人年)、65例(4.37/万人年)。Log-rank检验结果显示,各分组之间累积发病率差异有统计学意义(χ^(2)=22.41,P<0.001)。多因素Cox回归模型显示:与Q1组比较,Q4组发生AP的HR=1.94,95%CI:1.20~3.13(P=0.01)。与TG累积暴露0年相比,累积暴露4、6年发生AP的HR分别是2.04(95%CI:1.26~3.30,P<0.01)、3.20(95%CI:1.98~5.17,P<0.01)。排除随访2年内发生的AP病例,重复多因素Cox回归分析,结果发现Q4组发生AP的HR=1.96,95%CI:1.23~3.12(P<0.01)。排除随访期间死亡人群后重复多因素Cox回归分析,结果发现Q4组发生AP的HR=1.85,95%CI:1.10~3.14(P<0.05)。结论随着cum TG的暴露增加,AP的发病率和发病风险均呈上升趋势。Objective To investigate the association between cumulative triglyceride(cumTG)exposure and the risk of acute pancreatitis(AP).Methods A prospective study was conducted for a cohort of 56883 workers from Kailuan Group who participated in annual physical examination for three consecutive times in 2006-2010(2006,2008,and 2010)and had complete TG data without the medical history of AP.According to the quartiles of cumTG calculated,the subjects were divided into four groups(Q1,Q2,Q3,and Q4 groups),and general information was compared between the two groups.A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups,and the Kruskal-Wallis H test was used for comparison of continuous data with skewed distribution between multiple groups;the chi-square test was used for comparison of categorical data between groups.The Kaplan-Meier method was used to plot the survival curve and calculate the cumulative incidence rate of AP,and the Log-rank test was used for comparison between groups;the Cox regression model was used to analyze the effect of different cumTG levels on new-onset AP events.Results After follow-up for 10.51±1.76 years,there were 158 AP events in total,with a total incidence density of 2.64 per 10000 person-years,and the number of cases and incidence density in the Q1,Q2,Q3,and Q4 groups were 29 cases(1.93 per 10000 person-years),34 cases(2.27 per 10000 personyears),30 cases(2.01 per 10000 person-years),and 65 cases(4.37 per 10000 person-years).The Log-rank test showed that there was a significant difference in cumulative incidence rate between groups(χ^(2)=22.41,P<0.001).The multivariate Cox regression analysis showed that compared with the Q1 group,the Q4 group had a significantly higher risk of AP(hazard ratio[HR]=1.94,95%confidence interval[CI]:1.20—3.13,P=0.01).Compared with cumulative triglyceride exposure for 0 year,cumulative triglyceride exposure for 4 and 6 years significantly increased the risk of AP,with an HR value of 2.04(95%CI:1.26�

关 键 词：甘油三酯类 急性胰腺炎 危险因素 

分 类 号：R576[医药卫生—消化系统]