脂肪肝在急性胰腺炎早期严重程度预测中的作用

The prognostic role of fatty liver in early prediction of acute pancreatitis severity

目的前瞻性研究脂肪肝在早期预测急性胰腺炎(acute pancreatitis;AP)严重程度中的作用。方法收集发病24h内送入苏州大学附属第一医院急诊的AP患者,并以腹部B超确认有无脂肪肝。共纳入100例AP非合并脂肪肝的患奢(非脂肪肝组)和100例AP合并脂肪肝(脂肪肝组)的患者。入院后行BISAP评分和APACHE Ⅱ评分,并根据患者发病后48h的临床及实验室检查结果判断AP的严重程度。结果与非脂肪肝组相比,脂肪肝组患者的入院时C反应蛋白、BISAP评分和APACHE Ⅱ评分明显增高。脂肪肝组发生MSAP和SAP的频率明显高于非脂肪肝组。脂肪肝组发生SAP的OR值为2.812(95%CI:1.944-8.259),发生MSAP+SAP的OR值为2.092(95%CI:1.066-4.108)。结论脂肪肝与AP重症倾向有关,并且是AP重症化的危险因素。

Objective The prospective study aimed to investigate the prognostic role of fatty liver in the early stage of acute pancreatitis(AP).Methods The patients with the onset of AP within 24 h were collected,and the fatty liver was diagnosed by abdominal ultrasound.100 AP patients without fatty liver and 100 AP patients with fatty liver were enrolled.BISAP score and APACHE Ⅱ score were evaluated after hospitalization.The severity of AP was confirmed by clinical manifestations and laboratory tests 48h after the onset.Results Compared with AP patients without fatty liver,obviously higher C-reactive protein level,BISAP score and APACHE Ⅱ score were found in AP patients with fatty liver.The frequency of MSAP and SAP in fatty liver group was significantly higher than that in non-fatty liver group.The OR value of SAP in fatty liver group was 2.812(95%CI:1.944〜8.259),and the OR value of MSAP+SAP was 2.092(95%CI:1.066-4.108).Conclusion Fatty liver is associated with the severe tendency of AP and may be used as an early predictor of AP severity.