143例急性胰腺炎病因回顾分析

Retrospective Analysis on Etiology of 143 Patients with Acute Pancreatitis

【目的】探讨急性胰腺炎的病因。【方法】回顾分析5年来本院收治的143例急性胰腺炎,详细调查患者的一般资料、实验室检查、影像学检查结果、治疗和转归情况,按照病因分为6组。【结果】143例患者的病因构成比为胆源性组58%,酗酒组占9.8%,暴饮暴食组占9.1%,高脂血症组占11.2%,少见原因组占5.6%,特发性组6.3%;各组年龄相比差异有显著性(F=4.825,P<0.01),酗酒和高脂血症组平均年龄要比胆源性组小(P<0.01);各组的男女比例相比差异有显著性(χ2=33.144,P<0.01),胆源性组女性占多数(60%),而在酒精组和高脂血症组患者中男性占多数(P<0.01);高脂血症组24 h内血淀粉酶明显低于其他组(P<0.01)。【结论】急性胰腺炎的病因逐渐被明确,病因构成在发生变化。在我国胆道疾病仍是急性胰腺炎的主要病因,而高脂血症因素比例在升高。

[Objective]To explore the etiology and pathogenesis of acute pancreatitis（AP）. [Methods] The clinical data of 143 patients with AP admitted to our hospital from January 2003 to December 2007 were reviewed to analyze the etiology and pathogenesis of AP, and were divided into 6 groups according to etiology. [Results]The constituent ratio of etiology of the 6 groups were biliary tract disease（54.4%）, alcoholic pancreatitis （9.8 0% ）, binge overeating （ 9.1 %）, hyperlipidemic acute pancreatitis（ 11.2 %）, other infrequent reason （5.6 % ）, and idiopathic pancreatitis （6.3 %）. There was significant difference in the average ages of all groups （F=4. 825, P 〈0.01）. The average age of alcohol and hyperlipidemia groups was significantly less than that of the biliary group （ P 〈0.01）. The number of female patients was significantly more than that of male patients in biliary group, but significantly less than that of male patients in alcohol and hyperlipidemia groups（ P 〈0.01）, and there was significant difference in percentage of sex of all groups（χ^2=33. 144, P 〈0.01）. The value on blood amylase of hyperlipidemia group within 24 hours after abdominal pain happened was significantly less than that of other groups（ P 〈0.01）. [Conclusion] The etiological factors of AP have been gradually identified, and the constituents of etiology of AP have also changed. In our country, the biliary tract disease is still the main reason of AP,however the percentage of hyperlipidemic acute pancreatitis is increasing.