脂代谢在急性高血脂性胰腺炎预后评估中作用与意义

Clinical significance of lipid metabolism in evaluating the prognosis of hyperlipidemic acute pancreatitis

目的探讨血脂代谢指标在急性高血脂性胰腺炎患者预后评估中作用与临床意义。方法回顾性分析2012年7月至2016年7月间我院收治的97例急性高血脂性胰腺炎患者的血脂代谢指标与MCTSI评分资料,探讨两者之间的相关性。结果急性高血脂性胰腺炎患者血清载脂蛋白A1(apo A1)水平与改良CT严重指数(MCTSI)评分呈负相关(F=10.004,P<0.05)。血清apo A1值低于正常值的患者中,MCTSI≥4分的人数明显高于MCTSI 2分人数(χ~2=9.343,P<0.05)。血清甘油三酯(TG),总胆固醇(TC),高密度脂蛋白胆固醇(HDL-C),低密度脂蛋白胆固醇(LDH-C),载脂蛋白B(apo B)和脂蛋白a(LP(A))水平与MCTSI评分无相关性(F=1.358,0.585,0.049,0.439,0.228,0.168,P>0.05)。结论血清apo A1水平是评估急性高血脂性胰腺炎患者病情严重程度较好的指标,与急性高血脂性胰腺炎病情严重程度呈负相关。

Objective To investigate the correlation between serum lipid metabolic indicators and MCTSI score in hyperlipi- demic acute pancreatitis. Methods The serum lipid metabolic indicators and MCTSI score data of 97 cases of hyperlipidemic acute pancreatitis were retrospectively analyzed from Jul. 2012 to Jul. 2016. The correlation of serum lipid metabolic indicators and MCTSI score were analyzed. Results The serum apoA1 level of hyperlipidemie acute panereatitis patients was negatively correlated with MCTSI score（ F = 10. 004, P 〈 0. 05 ）. In the patients with serum apoA1 values lower than that of normal value. The number of pa- tients whose MCTSI scores were ≥4 was significantly higher than that of those whose MCTSI scores were 2 （ χ2 = 9. 343, P 〈 0. 05 ）. But there was no significant correlation between MCTSI score and serum TG, TC. HDL-C, LDH-C, apoB and LP （A） levels （ F = 1. 358, 0. 585, 0. 049, 0. 439, 0. 228, 0. 168, P 〉 0. 05 ）. Conclusion Serum apoA1 level is better indicator to evaluate the severity of hyperlipidemic acute pancreatitis. There is negative correlation between severity of hyperlipidemic acute panereatitis and serum apoA1 level.