高脂血症性与非高脂血症性重症急性胰腺炎临床特点比较分析

The comparative analysis of clinical characteristics between the hyperlipidemic and non-hyperlipidemic severe acute pancreatitis

目的比较分析高脂血症性与非高脂血症性重症急性胰腺炎（SAP）的临床特点和预后。方法收集某院2007年1月～2013年1月收治的SAP患者临床资料121例，其中高脂血症性SAP31例（H—SAP组），非高脂血症性SAP90例（NH—SAP组）．分析比较两组疾病的临床特点、并发症以及预后。结果H—SAP组与NH—SAP组在性别、年龄、Ranson评分方面比较，差异均无统计学意义抄0．05），但H—SAP组体质量指数、既往胰腺炎发作吏、血三酰甘油、血糖明显高于NH—SAP组（P〈0.05）；急性呼吸窘迫综合征、胰性脑病、肝功能损伤发生率两组间比较，差异无统计学意义（P〉0．05），但H-SAP组多器官功能不全综合征、肾衰竭、应激性溃疡、休克发生率高于NH—SAP组（P〈0．05）；H—SAP组接受手术治疗者与NH—SAP组比较，差异无统计学意义（P0．05）：H—SAP组病死率高于NH—SAP组（P〈0．05）。结论高脂血症性胰腺炎病情较重，减少血脂升高的诱因，发病后积极降低血脂可能会提高疗效。

Objective Comparison analysis the clinical characteristics between the hyperlipidemic and non-hyperlipidemic severe acute pancreatitis （SAP）. Methods A total of 121 cases of SAP patients in our hospital were collected from January,2009 to January,2013 ,there were 31 case of hypedipidemic SAP （H-SAP group） and 90 case of non-hyperlipidemic SAP （NH-SAP group）, analyze the clinical characteristics,complications and mortality. Results There were no differences in gender composition,age, ranson score,and the rates of operation, pancreatic encephalopathy,ARDS and damage of liver function （P〉O.OS）,but in body mass index （BMI）,TG and serum glucose,H-SAP group are higher than that in NH-SAP group （P〈0.05）. And the rates of MODS,stress ulcer,renal failure and shock in H-SAP group were higher than those in NH-SAP group （P〈0.05）. The mortality of H-SAP group is higher than NH-SAP group （P〈0.05）. Conclusions Hyperlipidemie SAP are more serious than non-hyperlipidemic. The key to prevention and treatment of hypedipidemia SAP is to reduce the inducement of hoisting serum triglyceride and cut down the serum triglyceride.