甘油三酯水平与高脂血症性急性胰腺炎严重程度的关系

Relationship between the level of triglyceride and the severity of hyperlipidemic acute pancreatitis

目的探讨甘油三酯(TG)水平与高脂血症性急性胰腺炎(HLAP)严重程度的关系.方法选取2013年1月至2017年5月惠州市第一人民医院急诊内科收治后转入消化内科、肝胆外科、危重医学科的225例HLAP患者,对其一般资料进行回顾性分析.将患者按照血TG情况分为两组,低TG组103例,男69例,女34例,年龄(40.63±1.16)岁,年龄范围为38~65岁,高TG组122例,男92例,女30例,年龄(42.14±0.62)岁,年龄范围为40~67岁,对两组患者的合并症、生化指标、并发症发生情况及住院指标进行分析,比较两组患者的临床特征、严重程度及病死率.结果高TG组患者血糖水平[(13.82±0.78)mmol/L]高于低TG组[(11.03±0.93)mmol/L],总胆固醇[(10.18±0.72)mmol/L]高于低TG组[(7.61±0.38)mmol/L],血尿素氮[(8.09±1.27)mmol/L]高于TG组[(5.26±0.42)mmol/L],差异均有统计学意义(P<0.05).高TG组患者血钠含量[(130.83±0.47)mmol/L]低于低TG组[(137.43±0.42)mmol/L],差异有统计学意义(P<0.05).高TG组CT扫描下的局部并发症患者多于低TG组,AP严重情况高于低TG组,差异有统计学意义(P<0.05).低TG组患者ICU入住率[7.8%(8/103)]低于高TG组[21.3%(26/122)],差异有统计学意义(P<0.05).结论高TG的HLAP患者病情严重、ICU入住率高、CT扫描下的局部并发症发生率高,大多预后不良.

Objective To investigate the relationship between the level of triglyceride(TG)and the severity of hyperlipidemic acute pancreatitis(HLAP).Methods From January 2013 to May 2017,225 HLAP patients who were transferred to the Gastroenterology Department,Hepatobiliary Surgery Department and Critical Care Department were selected and their general data were retrospectively analyzed.The pa-tients were divided into two groups according to the blood TG condition:103 patients in the low TG group,69 males and 34 females,aged(40.63±1.16)years old and ranging from 38 to 65 years old;122 patients in the high TG group,92 males and 30 females,aged(42.14±0.62)years old and ranging from 40 to 67 years old.The complications,biochemical indexes,complications and hospitalization indexes of the two groups were analyzed,and the clinical characteristics,severity and mortality of the two groups were com-pared.Results Blood glucose level[(13.82±0.78)mmol/L]in the high-TG group was higher than that in the low-TG group[(11.03±0.93)mmol/L],total cholesterol[(10.18±0.72)mmol/L]was higher than that in the low-TG group[(7.61±0.38)mmol/L],and blood urea nitrogen[(8.09±1.27)mmol/L]was higher than that in the TG group[(5.26±0.42)mmol/L],and the differences were statistically significant(P<0.05).The blood sodium content[(130.83±0.47)mmol/L]in the high-TG group was lower than that in the low-TG group[(137.43±0.42)mmol/L],(P<0.05).Patients with local complications under CT scan in the high-TG group were more than those in the low-TG group,and the severity of AP was higher than that in the low-TG group(P<0.05).ICU occupancy rate of patients in the low TG group[7.8%(8/103)]was lower than that in the high TG group[21.3%(26/122)],(P<0.05).Conclusion HLAP patients with high TG have serious condition,high ICU occupancy rate,high incidence of local complications under CT scan,and most of them have poor prognosis.