非胆源性急性胰腺炎合并代谢综合征患者肝损伤特点分析

The clinical characteristics of liver injury in acute pancreatitis complicated with metabolic syndrome

目的探讨非胆源性急性胰腺炎合并代谢综合征患者肝损伤的临床特点。方法回顾性分析2014年12月至2016年12月本院收治的符合研究标准的63例伴代谢综合征的非胆源性急性胰腺炎患者(MS组)和145例不伴有代谢综合征的非胆源性急性胰腺炎患者(非MS组)的临床资料,比较两组入院时一般情况、体重指数(BMI)、C反应蛋白(CRP)、TG、血糖、丙氨酸转氨酶(ALT)、门冬氨酸转氨酶(AST)、总胆红素(TBIL)、白蛋白(ALB)等指标。结果 MS组患者体重指数、CRP、TG、血糖明显高于非MS组,差异均有统计学意义(P<0.05),MS组ALT[(123.4±16.7)U/L vs(63.8±8.5)U/L,P<0.05]、AST[(84.7±13.1)U/L vs(55.7±7.1)U/L,P<0.05]、TBIL[(32.3±12.9)U/L vs(21.7±10.4)μmol/L,P<0.05]均高于非MS组,差异有统计学意义(P<0.05)。MS组患者肝功能异常多表现为转氨酶和胆红素均升高,而非MS组患者肝功能异常多表现为转氨酶单纯升高。结论非胆源性急性胰腺炎合并代谢综合征患者肝损伤发生率较高,病情较重,在对此类患者的诊治中应密切监测肝功能变化,加强积极治疗。

Objective To investigate the clinical characteristics of liver injury in patients with Non-biliariogenous acute pancreatitis complicated with metabolic syndrome （MS）. Methods There were 63 patients complicated with MS （the MS group） and 145 patients without MS （the non-MS group） hospi- talized in our hospital were evaluated. The general conditions, body mass index （ BMI）, C reactive protein （CRP）, blood lipid （TG）, blood glucose, alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, total bilirubin （TBIL） and albumin （ALB） were compared between the two groups. Results BMI, CRP, blood lipid and blood sugar in MS group were significantly higher than those in non MS group （ P 〈 0. 05 ）. Levels of ALT [ （ 123.4 ± 16. 7 ） U/L vs （63.8 ±8.5 ） U/L,P 〈 0. 05 ], AST [ （ 84.7 ±13.1 ） U/L vs （55.7 ±7.1 ） U/L,P 〈 0. 05 ], TBIL [ （32. 3 ±12. 9） U/L vs （21.7 ±10.4） μmol/L,P 〈 0.05 ] in the MS group were higher than that in the non-MS group （ P 〈 0. 05 ）. The abnormal liver function in MS group was mostly elevated by AST and TBIL, but only elevation of AST in MS group. Conclusions The incidence of liver injury in patients with non biliary acute pancreatitis combined with metabolic syndrome is high and much heavier. In the diagnosis and treatment of such patients, the changes of liver function should be closely monitored and the active treatment should be strengthened.