病毒性肝炎并发急性胰腺炎24例临床预后分析

Clinical analysis of 24 patients with viral hepatitis concomitant with acute pancreatitis

目的探讨病毒性肝炎并发急性胰腺炎的临床特点和预后。方法回顾性分析近8年收治的24例病毒性肝炎并发急性胰腺炎患者的临床表现、实验室检查以及预后等方面的资料。结果24例患者中，重型肝炎合并急性胰腺炎者14例，其中好转者4例，恶化者10例；非重型肝炎合并急性胰腺炎患者10例，全部好转出院。HBV相关者21例，好转13例，恶化者8例；HEV相关者7例，全部恶化，其中3例病情加重自动出院，4例死亡。结论病毒性肝炎合并急性胰腺炎容易误诊。重型肝炎并发急性胰腺炎时预后明显差于非重型肝炎并发急性胰腺炎。HEV相关感染合并急性坏死性胰腺炎者的预后亦差于HBV相关感染合并急性坏死性胰腺炎者。

Objective To study the clinical features and prognosis of 24 patients with viral hepatitis concomitant with acute pancreatitis. Methods Analysis of the clinical data including symptoms and signs, laboratory findings, prognosis of the illness. Results Among the 24 cases, 14 patients were severe viral hepatitis concomitant with acute pancreatitis, in which only 4 of them took a favorable turn. Other lO patients were non-severe viral hepatitis concomitant with acute pancreatitis, in which all of them improve. Thirteen of 21 HBV-related patients but none of 7 HEV-related patients took turns for the better. Conclusions It is easily misdiagnosed for viral hepatitis concomitant with acute pancreatitis. The prognosis of severe viral hepatitis concomitant with acute pancreatitis and HEV-related patients were worse than non-severe viral hepatitis concomitant with acute pancreatitis and HBV-related patients.