| 摘要: |
| 目的:比较胆源性胰腺炎(BAP)和高脂血症性胰腺炎(HTGAP)的临床特征，为临床诊治提供参考证据。方法:收集整理天津市职业病防治院2018年12月—2020年12月收治的170例临床诊断为急性胰腺炎的病历资料，BAP组106例，HTGAP组64例，比较分析两组的临床基线数据、实验室检查和并发症等数据。结果:相比于BAP组，HTGAP组患者中位年龄较小(P<0.001)，体质指数(BMI)偏高(P<0.001)，伴有脂肪肝者居多(P=0.008)；HTGAP组患者白细胞计数、中性粒细胞计数、CRP、PCT水平均明显升高(P<0.05)，且血脂相关指标如TG、TC、LDL-C水平均高于BAP组，差异有统计学意义(P<0.001)。但BAP组患者电解质情况如血Na+、Ca2+水平均较HTGAP组高，差异有统计学意义(P=0.035，P=0.004)。虽然两组并发症总发生率无明显统计学差异(P=0.635)，但BAP组较HTGAP组的胰腺假性囊肿发生率提高，差异有统计学意义(P=0.007)。结论:BAP和HTGAP具有不同的临床特征。HTGAP好发于中青年，其患者BMI较高，且伴有血脂代谢紊乱等特点，同时HTGAP患者往往伴有严重的炎症反应。临床治疗中除了炎性指标外，血Ca2+也需要定期监测，以评估患者病情危重程度。对BAP患者而言，早期入院治疗，可以减轻胰腺假性囊肿的发生。 |
| 关键词: 急性胰腺炎 高脂血症性急性胰腺炎 胆源性急性胰腺炎 |
| DOI：10.3969/j.issn.1007-6948.2021.03.001 |
| 投稿时间：2021-01-09 |
| 基金项目: |
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| Analysis of Clinical Characteristics of Biliary Acute Pancreatitis and Hypertriglycerideia Induced Acute Pancreatitis |
| WANG Shu-jiang,ZONG He-ya |
| Department of Surgery,Tianjin Occupational Diseases Precaution and Therapeutic Hospital(Tianjin Workers' Hospital), Tianjin(300011), China |
| Abstract: |
| Objective To provide reference evidence for the clinical diagnosis and treatment of acute pancreatitis compared with the clinical characteristics of biliary acute pancreatitis and hypertriglyceridemia induced acute pancreatitis. Methods The medical records of 170 patients who were clinically diagnosed with acute pancreatitis from December 2018 to December 2020 at Occupational Diseases Precaution and Therapeutic Hospital were collected and analyzed. The clinical baseline data, laboratory tests, and complications of BAP and HTGAP were compared. Results In contrast to BAP, HTGAP patients had a younger median age (P<0.001), a higher BMI index (P<0.001) and more patients with fatty liver (P=0.008).White blood cell count, neutrophil count, CRP, and PCT levels w-ere significantly increased in HTGAP group (P<0.05), and serum lipid related indexes such as TG, TC and LDL-C levels were higher than those in BAP group, with statistical significance (P<0.001). However, the electrolyte status, such as blood Na+ and Ca2+ levels, were higher in the BAP group than in the HTGAP group, and the difference was statistically significant (P=0.035, P=0.004). Although there was no statistically significant difference in the total incidence of complications between the two groups (P=0.635), the incidence of pancreatic pseudocyst in the BAP group was higher than that in the HTGAP group, and the difference was statistically significant (P=0.007). Conclusion BAP and HTGAP each have distinct clinical characteristics. HTGAP is more common in young and middle-aged patients with a high BMI, dyslipidemia and other characteristics. Meanwhile, HTGAP patients are often associated with severe inflammatory reactions. In addition to inflammatory indicators in clinical treatment, blood Ca2+ also needs to be monitored regularly to evaluate the severity of the patient' s condition. For patients with BAP, early admission to hospital, perhaps reduces the incidence of pancreatic pseudocyst. |
| Key words: Acute pancreatitis biliary acute pancreatitis hypertriglyceridemiainduced acute pancreatitis |
