体质指数、血糖和血清三酰甘油与急性胰腺炎病情严重程度的关系

Relationship of Body Mass Index,Blood Glucose and Serum Triacylglycerol with Severity of Acute Pancreatitis

尽早对急性胰腺炎（AP）的病情严重程度作出准确评估，有助于快速诊断重症病例．及时开始正确的治疗。近年来，临床上起病时伴有代谢综合征（MS）的AP患者日趋多见。目的：探讨体质指数（BMI）、血糖和血清三酰甘油（TG）水平这三项MS组分指标与AP病情严重程度和预后的关系。方法：回顾2007年10月～2010年10月新疆医科大学第一附属医院住院AP患者的临床资料，分析入院时BMI、血糖、血清TG水平与Ranson评分、BalthazarCT分级、CT严重度指数（CTSI）的关系。结果：共398例AP患者纳入研究，重症患者的BMI、血糖、血清TG水平显著高于轻症患者（尸〈O．05）。Ranson评分≥3、BalthazarCT分级为D／E级和CTSI≥3的AP患者，BMI、血糖、血清TG水平分别显著高于Ranson评分〈3、BalthazarCT分级为A／B／C级和CTSI〈3的AP患者（P〈0．05）。根据Pearson相关系数，BMI、血糖、血清TG水平中的任意一项与Ranson评分、BahhazarCT分级、CTSI中的任意一项均呈显著正相关（P〈0．05）。结论：人院时BMI、血糖和血清TG水平能反映AP病情严重程度．可作为AP预后评估的参考指标。

Early assessment of severity of acute pancreatitis （AP） is helpful for the rapid diagnosis of severe case and administration of appropriate treatment. Recently, AP patients accompanied by metabolic syndrome （MS） at onset are increasingly seen in clinical practice. Aims： To investigate the relationship of MS components parameters including body mass index （BMI）, blood glucose and serum triacylglycerol （TG）, with severity and prognosis of AP. Methods： Clinical data of inpatients diagnosed as AP from Oct. 2007 to Oct. 2010 at the First Affiliated Hospital of Xinjiang Medical University were collected retrospectively. The relationship of BMI, blood glucose and serum TG at admission with Ranson score, Bahhazar CT grade and CT severity index （CTSI） were analyzed. Results： A total of 398 AP patients were enrolled. BMI, blood glucose and serum TG level in severe cases were significantly higher than those in mild cases （P〈0.05）. BMI, blood glucose and serum TG level in AP patients with Ranson score I〉3, Balthazar CT grade D or E and CTSI I〉3 were significantly higher than those in patients with Ranson score 〈3, Balthazar CT grade A, B or C and CTSI 〈3 （P〈0.05）. Pearson correlation coefficient analysis showed significant positive correlations between BMI, blood glucose, serum TG and Ranson score, Balthazar CT grade and CTSI （P〈0.05）. Conclusions： BMI, blood glucose and serum TG at admission can reflect the severity of AP and might be used as reference parameters for prognosis evaluation.