肥胖在急性胰腺炎患者的严重程度和预后判断中的价值

Value of obesity on the evaluation of severity and prognosis of patients with acute pancreatitis

目的探讨肥胖与急性胰腺炎的关系。方法对2007年1月—2012年11月间在天门市第一人民医院住院治疗的400例急性胰腺炎患者进行回顾性分析,将所有患者按病情分为轻症急性胰腺炎和重症急性胰腺炎,记录患者入院时年龄、体重指数、并发症、Ranson's评分和CT严重指数,分析体重指数与以上临床指标的相关性,并探讨体重指数与急性胰腺炎预后的关系。结果轻症急性胰腺炎组并发症百分比为16.1%,重症急性胰腺炎组为94.9%;轻症急性胰腺炎组死亡为0,重症急性胰腺炎组死亡百分比为25.6%,两者比较,差异均有统计学意义(P<0.01)。轻症急性胰腺炎组中肥胖者明显少于重症急性胰腺炎组,两者比较,差异具有统计学意义(P<0.01)。轻症急性胰腺炎组体重指数为(24.9±5.2)kg/m2,重症急性胰腺炎组体重指数(27.8±6.4)kg/m2;两者比较差异有统计学意义(P<0.01)。Ranson's评分、CT严重指数与体重指数具有显著的相关性(P<0.05)。结论肥胖是急性胰腺炎独立危险因素之一,肥胖可以作为急性胰腺炎的严重程度和预后判断的一个重要指标。

[ Objective] To study the relationship between obesity and acute pancreatitis. [ Methods] The medical records of 400 pa- tients with acute pancreatitis in the First People＇s Hospital of Tianmen City from January 2007 to November 2012 were analyzed ret- rospectively. All patients were divided into the mild acute pancreatitis and the severe acute pancreatitis. The age, Body mass index （ BMI ）, complications, Ransong scores and CT severity index of patients on admission were collected, the correlation between BMI and these indexes was analyzed, and the relationship between BMI and prognosis of acute pancreatitis was discussed. [ Results] The incidence rate of complications in the mild acute pancreatitis group and the severe acute pancreatitis group was 16. 1% and 94.9% respectively, while the fatality rate of two groups was 0 and 25.6% , and the differences were significant（P 〈0.01）. The obesity patients in the mild acute pancreatitis group were significantly less than those in the severe acute pancreatitis group （P 〈0.01}. The average BMI in the mild acute pancreatitis group and severe acute pancreatitis group was [ 24. 9 ± 5.2 ） kg/m2 and （27.8 ± 6.4） kg/m2, and the difference was significant （P 〈 0.01）. Ranson＇s scores and CT severity index had significant corre- lation with BMI （P 〈 0.05）. [ Conclusion ] Obesity is one of independent risk factors for acute pancreatitis, so it can be used as an important index to evaluate the severity and prognosis of acute pancreatitis.