高脂血症性胰腺炎54例临床分析

Clinical analysis of 54 patients with hyperlipidemic acute pancreatitis

目的探讨高脂血症性胰腺炎(Hyperlipidemic acute pancreatitis,HLAP)的临床特点及预后。方法回顾性分析我院2007年1月至2012年1月收治的54例HLAP的临床资料,并与同期入院的229例胆源性胰腺炎(Acute biliary pancreatitis,ABP)进行比较。结果 HLAP患者以男性居多,男女比例为1.8:1,发病平均年龄(38.0±7.8)岁,合并血糖升高者46例,占85.2%;脂肪肝者42例,占77.8%;血淀粉酶正常者9例,占16.7%;血淀粉酶小于正常上限3倍者32例,占59.3%。与ABP组比较,HLAP组男性比例高、发病年龄低;血糖水平及脂肪肝发生率高;而血淀粉酶水平明显低于ABP组;重症胰腺炎的比例明显高于ABP组,平均住院日较ABP组长(P<0.05),胰腺炎复发次数多。结论应重视对HLAP的早期诊断,尽早对高脂血症病因进行干预,积极进行饮食习惯及生活方式的健康宣教,预防胰腺炎的复发。

Objective To investigate the clinical characteristics and prognosis of hyperlipidemic acute pan- creatitis （HLAP）. Methods The clinical data of the patients with HLAP in our hospital from Jan. 2007 to Jan. 2012 was retrospectively analyzed （the HLAP group）, and then compared with the clinical data of 229 patients with acute biliary pancreatitis during the period （the ABP group）. Results 65% of the patients were male, with male to female ratio of 1.8：1 and the average onset age of 38 years old. Forty-six patients （85.2%） were complicated with blood glu- cose elevation, and 42 patients （77.8%） were complicated with fatty liver. Nine patients （16.7%） were with normal he- modiastase, and 32 were with hemodiastase three times lower than the upper normal limit. Compared with the ABP group, the HLAP group had more male and younger patients, higher levels of blood glucose and higher incidence of fatty liver, as well as lower levels of hemodiastase. The incidence of severe panereatitis was significantly higher in the HLAP group than the ABP group, with longer length of hospital stay and higher recurrence rate. Conclusion Early diagnosis of HLAP is of great importance and treatment aiming at etiological factors should be carried out to allay the symptoms and prevent relapse of the disease. So good eating habits and lifestyle is of great importance.