高脂血症性急性胰腺炎患者血糖变化特点分析

Characteristics Analysis of Blood Sugar Changes of Acute Pancreatitis with Hyperlipidemia

目的观察高脂血症性急性胰腺炎(hyperlipidemic acute pancreatitis,HLP-AP)患者血糖变化特点。方法回顾中国石油大学(华东)医院消化内科2016年1月—2019年6月收治的173例急性胰腺炎(Acute Pancreatitis,AP)患者,按病因分为HLP-AP组,急性胆源性胰腺炎(Acute biliary pancreatitis,ABP)组及其他类型AP组。观察HLP-AP患者血糖变化特点,记录住院期间对血脂异常有无处理,及其对AP预后、血糖变化有无影响。结果HLP-AP组2型糖尿病(T2DM)检出率较ABP组及其他类型AP组高(P<0.05);非伴有2型糖尿病(且未经降糖治疗)患者,HLP-AP组平均空腹血糖水平高于ABP组(10.33±3.03 vs 6.76±2.18,P<0.05)及其他类型AP组(10.33±3.03 vs 6.60±2.87,P<0.05)。TG<5.6 mmol/L组T2DM患病率均低于5.6~11.3 mmol/L组(P<0.05)及TG>11.3 mmol/L组(P<0.05);TG>11.3 mmol/L组AP复发率较TG<5.6 mmol/L组高(P<0.05)。降脂治疗组复发率较未降脂处理组复发率降低(P<0.05)。复发患者首次入院时空腹血糖明显高于未复发患者(P<0.05),复发患者AP再次复发时空腹血糖高于首次入院(P<0.05),复发患者中降脂治疗后血糖平均水平低于非降脂治疗组(P<0.05)。结论高脂血症性AP患者更容易导致血糖升高,降脂治疗可以有效减少AP复发率并可改善糖代谢紊乱。

Objective To observe the characteristics of blood glucose in hyper lipidemic acute pancreatitis.Methods 173 cases of acute pancreatitis in the Digestive Department of the hospital from January,2016 to June,2019 were analyzed retrospectively.They were divided into the hyperlipidemic acute pancreatitis group,acute biliary pancreatitis and other types of acute pancreatitis according to the etiological factors.The feature of the blood glucose in hyper lipidemic acute pancreatitis,the influence of lipid-lowering therapy to the recurrence rate of acute panereatitis and to the blood glucose levels were observed.Results The HLP-AP group had higher level of the morbidity of type 2 diabetes than the other groups(P<0.05).The levers of the blood glucose in the patients not with type 2 diabetes and not with hypoglycemic therapy were higher in the HLP-AP group the the ABP group(10.33±3.03 vs 6.76±2.18,P<0.05)and the other types of group(10.33±3.03 vs 6.60±2.87,P<0.05).The detection rate of type 2 diabetes was lower in the TG<5.6mmol/L group than the 5.6~11.3mmol/L group(P<0.05)and TG>11.3mmol/L group(P<0.05).The recurrence rate of acute pancreatitis in the TG>11.3mmol/L group was higher than the TG<5.6mmol/L group(P<0.05)and with antilipemic therapy(P<0.05).The blood sugar of the relapsing patients in the first time was higher than the other patients(P<0.05).The blood sugar of recidivation was higher than the first time(P<0.05).The relapsing patients have a lower level of the blood sugar after lipid-lowering therapy(P<0.05).Conclusion Hyper lipidemic acute pancreatitis can lead to a higher blood glucose level.Lipid-lowering therapy can reduce the recurrence rate of acute pancreatitis and improve the blood sugar metabolism.