高甘油三酯血症性急性胰腺炎炎性指标特征及影响因素分析

Analysis of inflammatory markers and influencing factors of hypertriglyceridemia-induced acute pancreatitis

目的探讨高甘油三酯血症性急性胰腺炎(HLAP)相关炎性指标及其预后相关高危因素。方法回顾性分析47例HLAP和71例胆源性胰腺炎(ABP)患者入院后外周血白细胞总数(PBLC)、血淀粉酶、尿淀粉酶、血脂肪酶、总胆固醇、甘油三酯、血糖、CRP、IL-6、降钙素原水平,并进行多因素回归分析预后影响因素。结果 HLAP组的BMI、总胆固醇、甘油三酯、CRP、降钙素原、IL-6与ABP组比较差异均有统计学意义(P均<0.05)。HLAP组腹腔感染、肺部感染并发症发生率均低于ABP组(P均<0.05),随访6个月HLAP组复发率高于ABP组(P<0.05)。Logistic回归分析显示BMI、CRP、IL-6、降钙素原是HLAP预后的独立影响因素。结论重视HLAP患者的炎性指标变化特征,对于降低并发症发生率、减少复发及改善预后有重要意义。

Objective To investigate the inflammatory markers and prognostic risk factors of hypertriglyceridemiainduced acute pancreatitis(HLAP).Methods A total of 47 cases of HLAP and 71 cases of acute biliary pancreatitis(ABP)were enrolled in this study.After admission,the peripheral blood leukocyte count(PBLC),blood amylase(AMY),urine amylase(UAMY),blood lipase(LPS),total cholesterol(TG),triglyceride(TC),blood glucose(Glu),Creactive protein(CRP),IL6 and procalcitonin(PCT)were retrospectively analyzed.The multivariate logistic regression analysis was performed to identify the risk factors of clinical prognosis.Results The body mass index(BMI),TG,TC,CRP,PCT and IL6 significantly differed between the HLAP and ABP groups(allP<0.05).In the HLAP group,the incidence of abdominal and pulmonary infection was significantly lower compared with that in the ABP group(bothP<0.05).During 6month followup,the recurrence rate in the HLAP group was considerably higher than that in the ABP group(P<0.05).Logistic regression analysis demonstrated that BMI,CRP,IL6 and PCT were the independent risk factors of clinical prognosis of HLAP patients.Conclusions The changes of the characteristics of inflammatory markers should be intimately monitored,which plays a significant role in reducing the incidence of complications,lowering the recurrence rate and enhancing the clinical prognosis of HLAP patients.