妊娠期高三酰甘油血症型胰腺炎危险因素分析

Risk factors of hypertriglyceridemic pancreatitis during pregnancy

[目的]探讨妊娠期发生高三酰甘油血症型胰腺炎的危险因素。[方法]选择妊娠期高三酰甘油血症型胰腺炎40例作研究对象(研究组),并选择同期就诊的40例妊娠期非高三酰甘油血症的胰腺炎患者作为对照组。采用单因素分析就诊时的相关指标,如年龄、孕程、孕次、产次(初产、经产)、体质量指数、合并脂肪肝、合并妊娠期糖尿病或2型糖尿病、血清三酰甘油水平、血清胆固醇水平、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、D-二聚体浓度、血清钠、血清钙、中性粒细胞/淋巴细胞等指标。将其中有统计学意义的指标(P<0.05)进一步纳入多因素非条件Logistic回归分析,明确妊娠期发生高三酰甘油血症型胰腺炎的危险因素。[结果]研究组与对照组在孕程、体质量指数、合并脂肪肝、合并妊娠期糖尿病或2型糖尿病、血清三酰甘油水平、血清胆固醇水平、D-二聚体浓度、血清钠等方面比较,差异均有统计学意义(P<0.05)。将上述指标纳入多因素非条件Logistic回归分析发现,孕程(P=0.000,OR=0.845,95%CI:0.772~0.925)、体质量指数(P=0.000,OR=0.436,95%CI:0.305~0.624)、合并妊娠期糖尿病或2型糖尿病(P=0.000,OR=0.091,95%CI:0.032~0.262)、血清三酰甘油水平(P=0.000,OR=0.349,95%CI:0.205~0.595)、D-二聚体浓度(P=0.000,OR=0.196,95%CI:0.094~0.405)、血清钠(P=0.000,OR=1.675,95%CI:1.310~2.414)是妊娠期发生高三酰甘油血症型胰腺炎的独立危险因素(P<0.01)。[结论]积极干预诱发妊娠期高三酰甘油血症型胰腺炎的高危因素,从而降低妊娠期高三酰甘油血症型胰腺炎的发病率,对确保母婴儿安全具有重要意义。

[Objective]To investigate the risk factors of hypertriglyceridemic pancreatitis during pregnancy.[Methods]Forty cases of hypertriglyceridemic pancreatitis during pregnancy admitted to Maternal and Child Health Hospital of Hubei Province from January 2010 to April 2021 were retrospectively analyzed.A total of 40 patients with non-hypertriglyceridemic pancreatitis during pregnancy were enrolled into the control group.Univariate analysis was used to analyze the relevant indicators at the time of visit, including age, gestational age, pregnant times, productive times(first-timer, multiparity),body mass index(BMI),fatty liver, the combining gestational diabetes or type 2 diabetes, serum triglyceride level, serum cholesterol, low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),D-dimer concentration, serum sodium, serum calcium, neutrophils/lymphocytes and other indicators.The indicators with statistical significance(P<0.05)were further included in multivariate unconditional logistic regression analysis to identify risk factors for hypertriglyceridemic pancreatitis during pregnancy.[Results]The differences of gestational age, body mass index(BMI),fatty liver, the combining gestational diabetes or type 2 diabetes, serum triglyceride levels, serum cholesterol levels, D-dimer concentration, serum sodium between the hypertriglyceridemic pancreatitis during pregnancy group and control group were statistically significant(P<0.05).The above indicators were included in multivariate unconditional logistic regression analysis.Gestational age(P=0.000,OR=0.845,95%CI:0.772-0.925),body mass index(P=0.000,OR=0.436,95%CI:0.305-0.624),gestational diabetes mellitus or type 2 diabetes mellitus(P=0.000,OR=0.091,95%CI:0.032-0.262),serum triglyceride level(P=0.000,OR=0.349,95%CI:0.205-0.595),D-dimer concentration(P=0.000,OR=0.196,95%CI:0.094-0.405),serum sodium(P=0.000,OR=1.6)75,95%CI:1.310-2.414)were independent risk factors for hypertriglyceridemic pancreatitis during pregnancy(P<0.01).[Conclusion]The high risk factors of hypertriglyceridemic pancreatitis during pregnancy can be induced by active intervention, so as to reduce the incidence of hypertriglyceridemic pancreatitis during pregnancy, to ensure the mother and child safety is of great significance.