新疆地区500例急性胰腺炎患者病因学及严重度的危险因素分析

Analysis in etiology and risk factors of severity in 500 patients with acute pancreatitis in Xinjiang area

目的探讨新疆地区急性胰腺炎患者病因学及严重度的危险因素。方法选取急性胰腺炎患者500例,分析患者性别、年龄、病因、临床分型等临床资料,以酒精性、胆源性、高脂血症性、饮食性、其他病因、多因素、特发性进行病因分组,以18~24岁、25~39岁、40~64岁、>65岁进行年龄分组。对不同性别、年龄段及严重度的病因分布情况进行分析。分析降钙素原、C反应蛋白与急性胰腺炎严重程度的关系。结果胆源性急性胰腺炎129例(25.8%),显著多于其他病因组患者(P<0.05)。胆源性病因在女性中的比例显著高于在男性中的比例(P<0.05),酒精性病因在女性中的比例显著低于在男性中的比例(P<0.05),而高脂血症性在男性和女性患者病因中均占较高比例。各年龄段病因中胆源性AP的比例均最高,与其他病因相比差异均有统计学意义(P<0.05)。MAP病因中胆源性比例最高,与其他病因相比差异有统计学意义(P<0.05),其次为特发性、其他因素;SAP病因中高脂血症性比例最高,与其他病因相比差异有统计学意义(P<0.05)。SAP患者的PCT和CRP水平均显著高于MAP患者(P<0.05)。PCT和CRP水平与Ranson评分、Balthazar CT评分、APACHEⅡ评分正相关。结论急性胰腺炎的发生与多种危险因素有关,其中胆道疾病为急性胰腺炎的主要危险因素。

Objective To explore the etiology and the risk factors of severity in patients with acute pancreatitis（AP） in Xinjiang area.Methods A total of 500 patients with AP were selected,and the age,gender,etiology,clinical pancreatitis types were analyzed.Patients were divided into different groups according to alcoholic,biliary,hyperlipidemia,diet,other causes,multiple factors,idiopathic pathogens,and the patients were also divided into different groups according to age such as 18 to 24,25 to 39,40 to 64 and over 65.The distribution of etiology in patients with different gender,age and severity were analyzed.Relationship between procalcitonin,C reactive protein and severity of acute pancreatitis were analyzed.Results There were 129 cases with biliary acute pancreatitis（25.8%）,which were significantly higher than those of patients with other pathogens（P〈0.05）.The proportion of female patients with biliary disease was significantly higher than that of male patients（P〈0.05）,the proportion of female patients with alcoholic etiology was significantly lower than that of male patients（P〈0.05）,and the proportion of hyperlipidemia was high in the etiology of both male and female patients.The proportion of AP was the highest in the etiology in each age group（P〈0.05）.The proportion of biliary was the highest in the etiology of MAP（P〈0.05）,followed by idiopathic and other factors.Proportion of hyperlipidemia was the highest in the etiology of SAP（P〈0.05）.The levels of PCT and CRP in patients with SAP were significantly higher than those in patients with MAP（P〈0.05）.The levels of PCT and CRP were positively correlated with Ranson score,Balthazar CT score and APACHE score.Conclusion The occurrence of AP is related with multiple factors,in which biliary tract disease is the main risk factor of AP.