ERCP术后高淀粉酶血症发生情况及其影响因素分析

Analysis of the occurrence and influencing factors of hyperamylaseemia after ERCP

目的观察经内镜逆行胰胆管造影(ERCP)术后高淀粉酶血症发生情况,并对影响高淀粉酶血症发生的因素进行分析,旨在为未来ERCP术后高淀粉酶血症的防治提供指导。方法回顾性分析2015年10月—2019年6月于北京市顺义区医院接受ERCP术治疗的112例患者的临床资料,根据术后高淀粉酶血症发生与否进行分组,采用logistic多元回归模型分析ERCP术后高淀粉酶血症发生的影响因素。结果全部112例患者ERCP术后24例发生高淀粉酶血症,88例ERCP术后未发生高淀粉酶血症,发生率为21.43%。发生组胆总管狭窄、十二指肠乳头憩室占比均高于未发生组,PT、GGT、TG水平均高于未发生组,差异有统计学意义(P<0.05)。单因素及多因素logistic回归显示,有胆总管狭窄、有十二指肠乳头憩室、高PT水平、高GGT水平、高TG水平均是ERCP术后发生高淀粉酶血症的影响因素(OR>1,P<0.05)。结论胆总管狭窄、十二指肠乳头憩室、高PT水平、高GGT水平、高TG水平可能会增加ERCP术后高淀粉酶血症发生风险,临床应重视对存在上述风险因素的患者实施合理干预,可能对减少发生率、改善预后有积极意义。

Objective To observe the occurrence of hyperamylaseemia after endoscopic retrograde cholangiopancreatography(ERCP),and to analyze the factors affecting the occurrence of hyperamylaseemia,aiming to provide the prevention and treatment of hyperamylaseemia after ERCP in the future guide.Methods The clinical data of 112 patients who underwent ERCP treatment at the Hospital of Shunyi District Beijing from October 2015 to June 2019 were retrospectively analyzed,and they were divided into groups based on whether postoperative hyperamylaseemia occurred or not,logistic multiple regression model was used to analyze the influencing factors of hyperamylaseemia after ERCP.Results All 112 patients developed hyperamylaseemia after ERCP in 24 cases,and 88 cases did not develop hyperamylaseemia after ERCP.The incidence rate was 21.43%.The proportions of common bile duct stenosis and duodenal papillary diverticulum in the occurrence group were higher than those in the non-occurring group,and the levels of PT,GGT and TG were higher than those in the non-occurring group,and the differences were statistically significant(P<0.05).Univariate and multivariate logistic regression showed that common bile duct stenosis,duodenal papillary diverticulum,high PT level,high GGT level,and high TG level were the influencing factors of hyperamylaseemia after ERCP(OR>1,P<0.05).Conclusion Common bile duct stenosis,duodenal papillary diverticulum,high PT level,high GGT level,and high TG level may increase the risk of hyperamylaseemia after ERCP.The clinic should pay attention to the implementation of reasonable interventions for patients with the above risk factors.It may be of positive significance to reduce the incidence and improve the prognosis.