重症高三酰甘油血症急性胰腺炎的危险因素分析

Analysis of risk factors for severe hypertriglyceridemic pancreatitis

目的 分析高三酰甘油血症急性胰腺炎(HTGP)重症患者的危险因素。方法 回顾性分析南开医院2014年1月至2018年12月收治的HTGP患者599例,记录患者一般资料、入院24h内临床检验等资料,统计分析重症患者的危险因素。结果 单因素分析HTGP重症患者的危险因素包括:腹腔感染、感染性休克、急性呼吸衰竭、急性肾衰竭,以及高肌酐、高尿素氮、低血钙、高C反应蛋白、高血糖等生化指标异常(P<0.05)。Logistic回归分析显示:年龄大于45岁、血钙大于或等于1.5mmol/L、肌酐大于或等于133μmol/L的重症风险约为年龄小于或等于45岁、血钙小于1.5mmol/L、肌酐<133μmol/L者的0.085、0.387和9.265倍。HTGP程度与TG水平无明显相关性(r=0.039,P=0.826),与年龄呈负相关(r=-0.086,P<0.05)。结论 HTGP患者伴随低龄(≤45岁)、低血钙(<1.5mmol/L)、高肌酐(≥133μmol/L)出现重症的风险越高。

Objective To analyze the risk factors for patients with severe hypertriglyceridemic pancreatitis(HTGP).Methods A total of 599 patients with HTGP admitted to Nankai Hospital from January 2014 to December 2018 were retrospectively analyzed.The general information of patients and laboratory data within 24 h of admission were recorded.The risk factors of severe patients were statistically analyzed.Results The risk factors for severe HTGP analysed by using univariate segmentation analysis were abdominal infection,septic shock,acute respiratory failure,acute renal failure and abnormal biochemical indexes,including high creatinine,high urea nitrogen,hypocalcemia,high C-reactive protein,hyperglycemia and so on(P<0.05).Logistic regression analysis showed that the serious risk of patients with age>45 years old,level of blood serum calcium≥1.5 mmol/L,level of creatinine≥133μmol/L was 0.085,0.387 and 9.265 times of patients with age<45 years old,level of blood serum calcium<1.5 mmol/L and level of creatinine<133μmol/L.The HTGP severity was negatively correlated with age(r=-0.086,P<0.05),while no significant correlation was found between HTGP severity and TG level(r=0.039,P=0.826).Conclusion The higher risk of severe HTGP is associated with younger age(≤45 years old),lower serum calcium level(<1.5 mmol/L),and higher creatinine level(≥133μmol/L).