急性胰腺炎合并糖尿病18例分析

Analysis of acute pancreatitis complicated with diabetes mellitus: a report of 18 cases

目的:探讨急性胰腺炎(AP)合并糖尿病患者的临床特点,提高对此类患者诊断及治疗的认识。方法:回顾性分析58例AP患者的临床资料,其中轻症AP(MAP)41例,重症AP(SAP)17例;单纯AP(对照组)40例,AP合并糖尿病(观察组)18例,测定患者的随机血糖、空腹血糖、总胆固醇(TC)、三酰甘油(TG)、糖化血红蛋白(Hb A1c)、血Ca^(2+)浓度、C反应蛋白(CRP)等,对SAP患者进行急性生理与慢性健康(APACHEⅡ)评分,分析比较2组患者的生化指标及APACHEⅡ评分。结果:观察组患者随机血糖、空腹血糖、HbA1c、血Ca^(2+)浓度、SAP的发生率和APECHEⅡ评分均明显高于对照组(P<0.01)。结论:AP合并糖尿病患者的病情相对单纯AP患者更重,高血糖可能是早期AP病情加重的重要因素。

Objective： To investigate the clinical characters of the patients with acute pancreatitis（ AP） complicated with diabetes mellitus,and improve the understanding of the disease diagnosis and treatment. Methods： The clinical data of 41 patients with mild acute pancreatitis（ MAP） and 17 patients with severe acute pancreatitis（ SAP） were retrospectively analyzed. Forty patients with simple AP and 18 patients with AP complicated with diabetes were divided into the control group and observation group,respectively. The levels of triglyceride（ TG）,hemoglobin A1c（ Hb A1c）,serum calcium and C-reactive protein（ CRP） in all patients were measured,and the scores of Acute Physiology and Chronic Health Evaluation（ APACHEⅡ） in SAP patients were evaluated. Biochemical Indexes,acute physiology and chronic health evaluation（ APACHE Ⅱ） score between two groups were compared. Results： The levels of the bloodglucose,fasting blood-glucose,Hb A1 c and serum calcium,the incidence of SAP and the scores of APECHEⅡ in observation group were significantly higher than those in control group（ P〈0. 01）. Conclusions： Compared with the simple AP patient,the disease condition in AP patients complicated with diabetes are more serious. The high level of serum glucose maybe an important aggravation factor in AP patients.