[1]王志勇,唐森森,付海珍,等.高甘油三酯血症型急性胰腺炎严重程度和临床预后的相关性[J].医学信息,2022,35(14):57-61.[doi:10.3969/j.issn.1006-1959.2022.14.012]
　WANG Zhi-yong,TANG Sen-sen,FU Hai-zhen,et al.Correlation Between Severity and Clinical Prognosis of Hypertriglyceridemic Acute Pancreatitis[J].Medical Information,2022,35(14):57-61.[doi:10.3969/j.issn.1006-1959.2022.14.012]
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高甘油三酯血症型急性胰腺炎严重程度和临床预后的相关性()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年14期
页码:
57-61
栏目:
论著
出版日期:
2022-07-15

文章信息/Info

Title:
Correlation Between Severity and Clinical Prognosis of Hypertriglyceridemic Acute Pancreatitis
文章编号:
1006-1959（2022）14-0057-05
作者:
王志勇; 唐森森; 付海珍; 等
（1.义乌復元第一医院消化内科，浙江 义乌 322001；2.瑞安市人民医院消化内科，浙江 瑞安 325200）
Author(s):
WANG Zhi-yong; TANG Sen-sen; FU Hai-zhen; et al.
(1.Department of Gastroenterology,Fuyuan First Hospital,Yiwu 322001,Zhejiang,China;2.Department of Gastroenterology,Zhejiang Ruian People’s Hospital,Ruian 325200,Zhejiang,China)
关键词:
高甘油三酯血症; 急性胰腺炎; 血液净化; 甘油三酯
Keywords:
Hypertriglyceridemia; Acute pancreatitis; Blood purification; Triglyceride
分类号:
R576
DOI:
10.3969/j.issn.1006-1959.2022.14.012
文献标志码:
A
摘要:
目的 确定适合作为急性胰腺炎（AP）独立危险因素的高甘油三酯（TG）评价标准，分析TG水平与急性胰腺炎严重程度和临床预后的相关性。方法 选取2018年5月-2020年5月在我院和协作医院住院期间诊断为高甘油三酯血症型急性胰腺炎（HTG-AP）的患者40例，根据入院时是否合并脏器功能障碍分为轻症胰腺炎组（20例）和中重症胰腺炎组（20例），将中重症胰腺炎组根据无急性肾损伤分为双重血浆置换/血浆置换组（DFPP/PE）和持续肾脏替代疗法（CRRT）+双重血浆置换/血浆置换组（DFPP/PE）。比较轻症胰腺炎组和中重症胰腺炎组性别、年龄、体重指数、白细胞、血小板、红细胞压积、C-反应蛋白（CRP）、前降钙素（PCT）、血糖、钙离子（Ca2+）、TG、总胆固醇、尿素氮（BUN）、肌酐、白蛋白（Alb）、丙氨酸氨基转移酶、总胆红素、血清淀粉酶、腹部CT或者超声、APACHEⅡ评分、Ranson评分、BISAP评分、MCTSI评分、改良MarshalⅠ评分、住院时间、并发症、临床症状及预后转归，比较DFPP/PE组和CRRT+ DFPP/PE组TG、TC水平，分析TG水平与急性胰腺炎严重程度的相关性。结果 轻症胰腺炎组和中重症胰腺炎组CRP、PCT、Alb、TG、Ca2+、BUN、APACHEⅡ评分、Ranson评分、BISAP评分、改良MarshalⅠ评分、MCTSI评分、总住院时间水平比较，差异有统计学意义（P＜0.05）；轻症胰腺炎组治疗前后TG水平比较，差异无统计学意义（P＞0.05），中重症胰腺炎组治疗后TG水平低于治疗前，差异有统计学意义（P＜0.05）；DFPP/PE组和CRRT+DFPP/PE组TG、TC治疗前后比较，差异有统计学意义（P＜0.05）；不同TG水平的患者的疾病严重程度及预后比较，差异有统计学意义（P＜0.05）；Spearman相关分析显示，TG水平与急性胰腺炎严重程度呈正相关（rs=0.617）。结论 血清TG水平与罹患HTG-AP风险及严重程度呈正相关，采取积极干预措施降低血清TG水平，可减少重症胰腺炎的发病率。
Abstract:
Objective To determine the evaluation criteria of high triglyceride (TG) as an independent risk factor for acute pancreatitis (AP), and to analyze the correlation between TG level and severity and clinical prognosis of acute pancreatitis.Methods A total of 40 patients with hypertriglyceridemic acute pancreatitis (HTG-AP) who were hospitalized in our hospital and collaborative hospital from May 2018 to May 2020 were selected and divided into mild pancreatitis group (20 cases) and moderate-severe pancreatitis group (20 cases) according to whether they had organ dysfunction at admission. The moderate-severe pancreatitis group was divided into double filtration plasmapheresis/plasma exchange group (DFPP/PE) and continuous renal replacement therapy (CRRT)+double filtration plasmapheresis/plasma exchange group (DFPP/PE) according to the absence of acute kidney injury. The gender, age, body mass index, white blood cells, platelets, hematocrit, C-reactive protein (CRP), procalcitonin (PCT), blood glucose, calcium (Ca2+), TG, total cholesterol, blood urea nitrogen (BUN), creatinine, albumin (Alb), alanine aminotransferase, total bilirubin, serum amylase, abdominal CT or ultrasound, APACHEⅡ score, Ranson score, BISAP score, MCTSI score, modified MarshalⅠ score, hospitalization time, complications, clinical symptoms and prognosis were compared between the mild pancreatitis group and the moderate-severe pancreatitis group. The levels of TG and TC in DFPP / PE group and CRRT+DFPP / PE group were compared, and the correlation between TG level and the severity of acute pancreatitis was analyzed.Results There were statistically significant differences in CRP, PCT, Alb, TG, Ca2+, BUN, APACHEⅡ score, Ranson score, BISAP score, modified MarshalⅠ score, MCTSI score, and total length of stay between mild pancreatitis group and moderate-severe pancreatitis group (P<0.05). There was no significant difference in TG level before and after treatment in the mild pancreatitis group (P>0.05). The TG level in the moderate-severe pancreatitis group was lower than that before treatment, and the difference was statistically significant (P<0.05). There was significant difference in TG and TC between DFPP/PE group and CRRT+DFPP/PE group before and after treatment (P<0.05). There was a statistically significant difference in the severity and prognosis of patients with different TG levels (P<0.05). Spearman correlation analysis showed that TG level was positively correlated with the severity of acute pancreatitis (rs=0.617).Conclusion Serum TG level is positively correlated with the risk and severity of HTG-AP. Active intervention measures to reduce serum TG level can reduce the incidence of severe pancreatitis.

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