高血脂症性急性胰腺炎患者血脂代谢特点及与凝血功能和预后的关系分析  

Analysis of serum lipid metabolism and its relationship with coagulation function and prognosis in patients with hyperlipidemia acute pancreatitis

作　　者：周岑 方鹏 刘剑 ZHOU Cen;FANG Peng;LIU Jian(Department of Gastroenterology,The Second People's Hospital of Jingdezhen,Jingdezhen,Jiangxi,333000,China)

机构地区：[1]景德镇市第二人民医院消化内科,江西景德镇333000

出　　处：《当代医学》2025年第1期24-28,共5页Contemporary Medicine

摘　　要：目的探究高血脂症性急性胰腺炎(hyperlipidemia acute pancreatitis,HLAP)患者血脂代谢特点及与凝血功能和预后的关系。方法回顾性分析2019年5月至2022年5月景德镇市第二人民医院收治的60例HLAP患者的临床资料。根据患者病情严重程度分为轻症组(n=22)、中-重症组(n=21)与重症组(n=17),比较3组血脂代谢水平[甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)]、凝血功能指标[凝血酶原时间(prothrombin time,PT)、凝血酶时间(thrombin time,TT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)],并采用Pearson相关分析探究HLAP患者血脂代谢水平与凝血功能水平的相关性。两组患者均随访28 d,根据患者预后分为多器官障碍综合征(multiple organ dysfunction syndrome,MODS)组(n=23)与非MODS组(n=37),并比较两组血脂代谢水平、凝血功能指标。结果重症组血清TG水平高于轻症组、中-重症组,且中-重症组高于轻症组,差异有统计学意义(P<0.05);而3组血清TC、LDL-C、HDL-C水平比较差异均无统计学意义。重症组PT、TT、APTT均长于轻症组、中-重症组,且中-重症组长于轻症组,差异有统计学意义(P<0.05)。Pearson相关分析结果显示,TG、TC与PT、TT、APTT均呈正相关(r>0,P<0.05);LDL-C、HDL-C与PT、TT、APTT均呈负相关(r<0,P<0.05)。MODS组血清TG、TC水平均高于非MODS组,血清LDL-C、HDL-C水平均低于非MODS组,差异有统计学意义(P<0.05)。MODS组PT、TT、APTT均长于非MODS组,差异有统计学意义(P<0.05)。结论HLAP患者的TG水平随患者病情严重程度加重而上升,而凝血功能则随之下降,且血脂水平与凝血功能之间存在相关性,不同预后的HLAP患者血脂及凝血功能也存在差异。Objective To investigate the characteristics of lipid metabolism and its relationship with coagulation function and prognosis in patients with hyperlipidemic acute pancreatitis(HLAP).Methods The clinical data of 60 patients with HLAP admitted to The Second People's Hospital of Jingdezhen from May 2019 to May 2022 were retrospectively analyzed,the they were divided into the mild group(n=22),medium-severe group(n=21),and the severe group(n=17)according to the severity of the disease.The levels of lipid metabolism(triglyceride[TG],total cholesterol[TC],low-density lipoprotein cholesterol[LDL-C],high-density lipoprotein cholesterol[HDL-C])and coagulation function(prothrombin time[PT],thrombin time[TT],activated partial thromboplastin time[APTT])among the three groups were compared.Pearson correlation analysis was used to explore the correlation between blood lipid metabolism and coagulation function in HLAP patients.Patients in both groups were followed up for 28 d,and they were divided into the multiple organ disorders syndrome(MODS)group(n=23)and the non-MODS group(n=37)according to the prognosis,lipid metabolism and coagulation function levels of the two groups were compared.Results The TG level in the severe disease group was higher than that in the mild disease group and the medium-severe disease group,and the medium-severe disease group was higher than the mild disease group,the differences were statistically significant(P<0.05);there were no significant differences in serum levels of TC,LDL-C and HDL-C among the three groups.PT,TT and APTT in the severe disease group were longer than those in the mild disease group and the medium-severe disease group,and the medium-severe disease group were longer than those in the mild disease group,the differences were statistically significant(P<0.05).Pearson correlation analysis showed that TG and TC were positively correlated with PT,TT and APTT(r>0,P<0.05).LDL-C and HDL-C were negatively correlated with PT,TT and APTT(r<0,P<0.05).Serum TG and TC levels in the MODS group

关 键 词：高血脂症性急性胰腺炎 血脂 凝血功能 预后 相关性 

分 类 号：R576[医药卫生—消化系统]