急性胰腺炎后发生糖尿病的危险因素分析

Analysis of risk factors for diabetes following acute pancreatitis

目的 比较急性胰腺炎(AP)后发生糖尿病患者与AP后未发生糖尿病的患者入院早期各项生理病理特征的不同,找出可能与AP后发生糖尿病的有关危险因素,以期早期发现3c型糖尿病(T3cDM),改善AP的预后。方法 选取2019~2021年于我科入住的AP患者为研究对象,入组患者从入院开始至出院后1年的随访期内,所有AP后出现T3c DM的患者为实验组,未出现T3c DM的患者为对照组,通过Logistic风险回归模型比较分析两组患者之间是否存在年龄、性别、AP病因、AP发作次数、AP严重程度、BMI以及AP发作期间最高血糖浓度等情况差异及影响大小。结果 两组患者在AP是否多次发作(χ^(2)=6.206,P=0.013)、AP患者入院时BMI(χ^(2)=4.085,P=0.043)及AP发作期间患者最高血糖浓度比较差异有统计学意义(χ^(2)=14.111,P<0.001)。结论 AP发生后,AP是否多次发作、AP患者入院时BMI及AP发作期间患者最高血糖浓度是影响AP后出现T3c DM的独立危险因素。

Objective To compare the physiological and pathological characteristics of patients with diabetes following acute pancreatitis(AP) and patients without diabetes following AP at the early stage of admission. In order to find out the risk factors that might be related to the development of diabetes following AP, so as to detect type 3 diabetes mellitus(T3cDM) early and improve the prognosis of AP. Methods Patients with AP admitted to our department from 2019 to 2021 were selected as the research objects. The enrolled patients were followed up from admission to one year after discharge. All patients with T3cDM were included in the experimental group. Patients without T3cDM were included in the control group. Logistic regression model was used to compare and analyze the differences between the two groups in age, gender, etiology of AP, frequency of AP attacks, severity of AP, BMI, and the maximum blood glucose concentration during AP attacks and the impact size. Results There were differences in multiple episodes of AP(χ^(2)=6.206, P=0.013), BMI of AP patients at admission(χ^(2)=4.085, P=0.043) and the highest blood glucose concentration of AP patients(χ^(2)=14.111, P<0.001). Conclusion Multiple episodes of AP, BMI of AP patients at admission and the highest blood glucose concentration of AP patients are independent risk factors for the occurrence of diabetes following AP.