CT评估人体脂肪面积与急性高脂血症性胰腺炎复发的相关性研究

Visceral adipose tissue area measured by computed tomography is correlated with recurrence and severity of hyperlipidemic acute pancreatitis

目的探讨人体脂肪对急性高脂血症性胰腺炎(hyperlipidemic acute pancreatitis,HLAP)复发的相关性。方法选取2015年1月至2017年11月就诊于陆军军医大学大坪医院HLAP患者92例。随访12个月,按照有无复发将患者分为未复发组和复发组。记录两组患者临床资料以及根据腹部CT图像获取的内脏脂肪(visceral adipose tissue, VAT)面积和皮下脂肪(subcutaneous adipose tissue, SAT)面积,分析HLAP复发的相关因素。结果未复发组45例,复发组47例。两组性别、年龄、甘油三酯、胆固醇、空腹血糖和SAT面积比较,差异均无统计学意义(P>0.05),两组内脏VAT面积比较,差异有统计学意义(P<0.05)。单因素分析显示,VAT与复发相关,多因素Logistic回归分析结果显示,VAT是HLAP复发的独立危险因素(OR=2.55,95%CI:1.18~5.54,P<0.05)。对复发组CTSI评分和VAT相关性分析显示,VAT还与HLAP严重程度有关(P<0.05)。结论 VAT与HLAP复发有一定的相关性,并且与复发性HLAP严重程度有相关性。

Objective To investigate the correlation between adipose tissue distribution and the relapse of hyperlipidemic acute pancreatitis(HLAP). Methods A total of 92 patients with HLAP treated in our hospital between January, 2015 and November, 2017 were enrolled in this study. All the patients were followed up for 12 months for relapse of HLAP. The clinical data were compared between the patients with and without relapse to analyze the factors associated with HLAP recurrence. Results Forty-seven patients experienced relapse of HLAP during the follow-up and 45 did not. No significant differences were found between the patients with and without relapse in gender, age, triglyceride, cholesterol, fasting blood glucose or subcutaneous adipose tissue(SAT) area measured on CT(P>0.05), but visceral adipose tissue(VAT) area differed significantly between the patients(P<0.05). Univariate analysis showed that VAT area was associated with HLAP recurrence. Multivariate logistic regression analysis revealed that VAT area was an independent risk factor for HLAP recurrence(OR=2.55, 95%CI: 1.18-5.54;P<0.05). Correlation analysis between CT severity index(CTSI) and VAT area in patients with HLAP recurrence suggested that VAT area was also correlated with the severity of recurrent HLAP(P<0.05). Conclusion VAT area as an independent risk factor of HLAP recurrence is also associated with the severity of recurrent HLAP.