高脂血症性与胆源性急性胰腺炎临床特点比较

A comparison of clinical features between hyperlipidemic acute pancreatitis and acute biliary pancreatitis

目的:对比研究高脂血症性急性胰腺炎(HLAP)与胆源性急性胰腺炎(ABP)的临床特点。方法:回顾性分析20例HLAP组患者与同期20例ABP组患者临床资料、血生化指标、胰腺炎评分、重症胰腺炎(SAP)发病率及影像学表现等的差异。结果:HLAP组脂肪肝患病率、胰腺炎复发率明显高于ABP组(P<0.01),而在年龄上较ABP组小(x2=-3.783,P=0.001);HLAP组血清总胆固醇(TC)、总甘油三酯(TG)、空腹血糖(FBG)均显著高于ABP组(P<0.05),而血淀粉酶(AMY)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、总胆红素(TBIL)、直接胆红素(DBIL)、血钙浓度、白细胞数均低于ABP组(P<0.05);HLAP组改良CT评分(MCTSI评分)≥4分、Ranson评分≥3分以及SAP比例均高于ABP组(均P<0.05);2组在肾周间隙改变、胰腺受累部位上存在差异。结论:HLAP患者在基础疾病、生化指标改变及影像学表现上和ABP组存在差异,且有容易复发、SAP发病率高等特点。

Objective： To compare the differences of clinical features between hyperlipidemic acute pancreatitis（HLAP） and acute biliary pancreatitis（ABP）. Methods： A total of 20 HLAP patients and 20 ABP patients were enrolled in the study, then the clinical characteristics, serum biochemicals, the score of AP, the ratio of severe cases, imaging findings were analyzed contrastively and retrospectively. Results： In HLAP group, more were complicated with fatty liver and recurrence rate was much higher, the mean age was lower compared to ABP group（P〈0.01）. The TC, TG, FBG were higher in the HLAP group（P〈0.05）, while the AMY, ALT, AST, ALP, TBIL, DBIL, serum calcium and leukocytes number were significant lower in the HLAP group（P〈0.05）. The proportion of MCTSI score≥4, Ranson score≥3 and the ratio of severe cases were higher in patients with HLAP than that in patient with ABP（P〈0.05）. There were differences in the change of perirenal space and involved parts between the two groups. Conclusion： The significant differences are existed in HLAP and ABP in clinical characteristics, serum biochemicals, the ratio of severe cases and imaging findings.