急性高脂血症性胰腺炎临床特征探讨

Investigation of the Clinical Features of Acute Hyperlipidemic Pancreatitis

目的通过对急性高脂血症性胰腺炎和急性胆源性胰腺炎的临床特征对比分析明确前者对临床诊断和治疗的指导意义。方法以该院收治的2010年1月—2013年12月128例急性胰腺炎患者作为研究对象,其中急性胆源性胰腺炎ABP92例、急性高脂血症性胰腺炎AHP23例、(酒精性胰腺炎8例以及其他类型5例)。比较分析二者在脂肪肝、糖尿病发生率以及肝功能受损和血淀粉酶等关系,(急性高脂血症性胰腺炎CTSI,ABPAPACHE评分高。结果急性高脂血症性胰腺炎在脂肪肝发生率、糖尿病发生率、血脂、重症急性胰腺炎等方面要显著高于急性胆源性胰腺炎,而在肝功能受损以及血清淀粉酶等方面明显低于急性胆源性胰腺炎,两者差异有统计学意义(P<0.05)。结论急性高脂血症性胰腺炎具有血脂高、血清淀粉酶低、病情重等和一般急性胰腺炎不同的临床特征,充分了解这些临床特征有利于进行临床诊断和治疗。

Objective To compare the clinical features of acute hyperlipidemic pancreatitis with that of acute gallstone pancreatitis so as to make clear its guide significances for the clinical diagnosis and treatment. Methods 128 patients with acute pancreatitis admitted to our hospital from January 2010 to December 2013 were selected as the research object, 92 with acute gallstone pan-creatitis, 23 with acute hyperlipidemic pancreatitis, 8 with alcoholic pancreatitis and 5 with pancreatitis of other type. In terms of the incidence of fatty liver, diabetes, impaired liver function and serum amylase, as well as of the CTSI score and ABPAPACHE score, the two groups were compared. Results In terms of the incidence of fatty liver, diabetes, hyperlipidemia, severe acute pan-creatitis, acute hyperlipidemic pancreatitis was significantly higher than acute gallstone pancreatitis; but in terms of the incidence of impaired liver function and serum amylase, the former was lower than the latter, and the differences were statistically significant （P〈0.05）. Conclusion Acute hyperlipidemic pancreatitis has the clinical features of high blood lipid, low serum amylase and severe illness status which were different with those of common acute pancreatitis. Fully understanding of these clinical features is con-ducive to clinical diagnosis and treatment.