高甘油三酯血症性急性胰腺炎诊治进展

Progress in diagnosis and treatment of hypertriglyceridemic acute pancreatitis

高甘油三酯血症性急性胰腺炎(hypertriglyceridemic acute pancreatitis,HTG-AP)日渐增多,且呈年轻化、重症化态势,已成为我国急性胰腺炎的第二大病因.已有的研究证实高甘油三酯血症的严重程度与急性胰腺炎的严重程度相关.但当前对其HTG及HTG-AP的发病机制尚不明了.HTG-AP治疗手段包括:低热卡喂养,胰岛素,肝素,降脂药物及血液净化等.这些治疗手段,尤其以血浆置换为代表的血液净化措施尽管在降低血脂水平方面的作用已得到证实,但其对于改善HTG-AP的预后尚需高质量的RCT研究证实.基因诊断与基因治疗在HTG-AP的诊治中的价值越来越受到重视,可能是今后HTG-AP研究的重要方向.

At present,the incidence of hypertriglyceridemic acute pancreatitis(HTG-AP)is on the rise,the age of onset tends to be younger,and severe HTG-AP is more common.HTG has become the second major cause of acute pancreatitis(AP)in China.Previous studies have demonstrated that the severity of hypertriglyceridemia correlates with the severity of AP.However,the pathogeneses of HTG and HTG-AP are still unknown.The treatments for HTG-AP include low-calorie diet,insulin,heparin,lipid-lowering drugs,and blood purification.Although these treatments,especially blood purification measures represented by plasma exchange,have been proven to reduce blood lipid levels,they still need to be confirmed by high-quality randomized controlled trials to improve the prognosis of HTG-AP.The value of gene diagnosis and therapy in the diagnosis and treatment of HTG-AP has attracted more and more attention,which may be an important direction of HTGAP research in the future.