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目的比较高三酰甘油血症胰腺炎(HTGP)和急性胆源性胰腺炎(ABP)的临床特征,旨在提高对HTGP的认知和诊疗水平。方法回顾性分析2013年1月至2015年9月收治的HTGP 38例和ABP 64例的临床资料,比较其一般资料、入院24 h生化指标、并发症、病情及预后。结果 1HTGP组男性、糖尿病、甲状腺功能减低、脂肪肝、肥胖者及既往发作史的比例均高于ABP组(均P<0.01或P<0.05),HTGP组年龄低于ABP组(P<0.01),HTGP组体质量指数(BMI)高于ABP组(P<0.01)。2HTGP组血淀粉酶(AMY)、尿AMY、血丙氨酸氨基转移酶(ALT)、血天门冬氨酸氨基转移酶(AST)、血碱性磷酸酶(ALP)、血总胆红素(TBIL)、血直接胆红素(DBIL)及血钙水平均低于ABP组(均P<0.01或P<0.05),空腹血糖(FBG)、血三酰甘油(TG)、血总胆固醇(TC)、血D-二聚体及血降钙素原(PCT)高于ABP组(P<0.05),血脂肪组(LPS)水平两组比较差异未见统计学意义(P>0.05)。3HTGP组继发糖尿病及并发症比率高于ABP组(P>0.05),HTGP组Ranson、APACHEⅡ、CTSI评分均高于ABP组(P均<0.05),HTGP组病死率高于ABP组(10.53%比1.56%,P>0.05)。结论与ABP比较,HTGP具有一些临床特征有助于早期诊断,其血尿清淀粉酶升高不显著,但并发症更多,病情更重,复发率更高,而积极降低TG对改善预后及复发具有重要价值。
Objective To compare the clinical features of hypertriglyceridemia pancreatitis (HTGP) and acute gallstone pancreatitis (ABP) in order to improve the cognition and diagnosis of HTGP. Methods The clinical data of 38 patients with HTGP and 64 patients with ABP admitted to our hospital from January 2013 to September 2015 were retrospectively analyzed. The general data, biochemical indexes, complications, condition and prognosis at 24 h after admission were compared. Results The proportion of male patients with diabetes, hypothyroidism, fatty liver, obesity and previous history in 1HTGP group were higher than that in ABP group (all P <0.01 or P <0.05), but lower in HTGP group than in ABP group (P <0.01) , Body mass index (BMI) in HTGP group was higher than that in ABP group (P <0.01). The levels of serum amylase (AMY), urine AMY, ALT, AST, ALP and total bilirubin in 2HTGP group TBIL, DBIL, and serum calcium were all lower than those in ABP group (all P <0.01 or P <0.05), fasting blood glucose (FBG), triglyceride (TG), total cholesterol ), Blood D-dimer and procalcitonin (PCT) were higher than those in ABP group (P <0.05). There was no significant difference between the two groups in blood lipid (LPS) level (P> 0.05). The rates of secondary diabetes and complications in 3HTGP group were higher than those in ABP group (P> 0.05). The scores of Ranson, APACHEⅡ and CTSI in HTGP group were higher than those in ABP group (P <0.05) Than 1.56%, P> 0.05). Conclusion Compared with ABP, HTGP has some clinical features which are helpful for early diagnosis. The serum amylase, amylase and amylase showed no significant increase in serum amylase, but had more complication, more serious disease and higher recurrence rate. However, HTGP decreased the prognosis and relapse Has important value.