中-重度急性胰腺炎患者的血清25-羟维生素D水平及其与预后的关系

Serum 25-hydroxyvitamin D level and its relation with prognosis in patients with moderate-to-severe acute pancreatitis

目的探讨中-重度急性胰腺炎(M-SAP)患者血清25-羟维生素D[25-(OH)D]的水平及其与预后的关系。方法选择41例M-SAP患者(M-SAP组)及30例健康体检者(对照组),并根据肥胖情况将M-SAP组分为肥胖组21例及非肥胖组20例。检测各组研究对象的血清25-(OH)D水平,记录M-SAP患者出院后3个月内局部并发症的发生情况,比较发生并发症及未发生并发症患者的25-(OH)D及白蛋白水平、急性生理及慢性健康状况Ⅱ评分、改良CT严重指数(MCTSI)评分,并分析M-SAP患者预后不佳的危险因素。结果 M-SAP组的25-(OH)D水平低于对照组,维生素D缺乏率高于对照组(均P<0.05);肥胖组的25-(OH)D水平低于非肥胖组(P<0.05)。MCTSI评分增高及维生素D严重缺乏是M-SAP患者预后不佳的危险因素(均P<0.05)。结论 M-SAP患者血清25-(OH)D水平降低,尤其是肥胖M-SAP患者。MCTSI评分增高、维生素D严重缺乏的M-SAP患者预后更差。

Objective To investigate serum 25-hydroxyvitamin D level[25-(OH)D] and its relation with prognosis in patients with moderate-to-severe acute pancreatitis(M-SAP). Methods Forty-one M-SAP patients (M-SAP group) and 30 healthy subjects receiving physical examination(control group) were enrolled,the M-SAP group was subdivided into obese group( n =21) and non-obese group( n =20) according to the incidence of obesity.Serum 25-(OH)D level was detected in the subjects in each group,the incidence of local complications within 3 months after discharge was recorded in the M-SAP patients,25-(OH)D and albumin levels as well as scores of Acute Physiology and Chronic Health Evaluation Ⅱ and modified CT severity index(MCTSI) were compared between patients with complication and without complications,risk factors for poor prognosis were analyzed in patients with M-SAP. Results The M-SAP group had a lower 25-(OH)D level and a higher rate of vitamin D deficiency compared with the control group(all P <0.05);the 25-(OH)D level of the obese group was lower than that of the non-obese group( P <0.05).Elevated MCTSI score and severe vitamin D deficiency were risk factors for poor prognosis in patients with M-SAP (all P <0.05). Conclusion Serum 25-(OH)D level is decreased in patients with M-SAP,especially in those with obesity . Patients suffering from M-SAP with elevated MCTSI score and severe 25-(OH)D deficiency have poorer prognosis.