早期血浆置换对重症高脂血症性胰腺炎患者的生化指标及预后的影响

Influence by early plasma exchange on biochemical index and prognosis in severe hyperlipidemic pancreatitis patients

目的观察早期血浆置换对重症高脂血症性胰腺炎(HLP)的生化指标改变及治疗效果。方法 40例重症高脂血症性胰腺炎患者,随机分为对照组23例和治疗组17例。对照组采用内科传统治疗;治疗组在对照组的基础上给予早期单次床旁血浆置换治疗。比较两组血患者常规白细胞(WBC)、血清淀粉酶(AMY)、血糖(GLU)、甘油三酯(TG)指标。结果治疗前,两组患者血常规WBC、AMY、TG、GLU比较,差异无统计学意义(P>0.05)。治疗后第3天,两组患者血常规WBC、AMY、TG、GLU低于治疗前(P<0.01);治疗组血常规WBC(7.89±1.53)×109/L、AMY(201.32±18.20)U/L、GLU(7.15±0.98)mmol/L、TG(5.82±3.01)mmol/L均低于对照组的(9.26±2.06)×109/L、AMY(252.43±19.08)U/L、GLU(8.43±1.66)mmol/L、TG(11.72±3.64)mmol/L(P<0.05)。结论重症高脂血症性胰腺炎患者采用早期行血浆置治疗能明显改善其生化指标,减少炎症反应发生,阻止病情发展。

Objective To observe biochemical index changes and curative effect by early plasma exchange for severe hyperlipidemic pancreatitis （HLP）. Methods A total of 40 patients with hyperlipidemic pancreatitis were randomly divided into control group with 23 eases and treatment group with 17 cases. The control group received conventional medical treatment, and the treatment group received additional single early bedside plasma exchange for treatment. Comparison was made on indexes of white blood cell （WBC）, serum amylase （AMY）, blood glucose （GLU）, and triglyceride （TG） between the two groups. Results Before treatment, there was no statistically significant difference of blood routine WBC, AMY, TG and GLU between the two groups （P〉0.05）. In the 3rd day after treatment, both groups had lower WBC, AMY, TG and GLU than those before treatment （P〈0.01）. The treatment group had all lower WBC as （7.89 ± 1.53） ×10^9/L, AMY as （201.32 ± 18.20） U/L, GLU as （7.15± 0.98） mmol/L and TG as （5.82 ± 3.01） mmol/L than WBC as （9.26 ± 2.06）×10^9/L, AMY as （252.43± 19.08） U/L, GLU as （8.43 ± 1.66） mmol/L and TG as （11.72± 3.64） mmol/L in the control group （P〈0.05）. Conclusion Implement of early plasma exchange can remarkably improve biochemical index in patients with severe hyperlipidemic pancreatitis, reduce inflammatory reactions and prevent disease development.