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目的探讨持续高血糖与急性胰腺炎(AP)早期病情发展的关系。方法本组共512例AP患者,其中轻型胰腺炎(MAP)418例,重症胰腺炎(SAP)94例。于入院时、入院第2天、第3天测定空腹血糖,作APACHEⅡ评分;入院第2天测定血清肿瘤坏死因子α(TNFα)、C反应蛋白(CRP)。结果SAP患者血糖升高(745%)的发生率明显高于MAP患者(258%),P=0001。SAP持续高血糖组的APACHEⅡ评分在入院时、入院第2天、第3天均高于非持续高血糖组[(13±4)对(11±3),P=0017;(13±4)对(11±3),P=0010;(14±4)对(10±4),P=0010]。持续高血糖与SAP严重度分级密切相关(χ2=777,P=0005)。持续高血糖组的血清TNFα[(20±14)对(14±11),P=0019]和CRP[(123±81)对(93±55),P=0036]水平均显著高于非持续高血糖组。结论持续高血糖可能是AP早期病情加重的一个危险因素。
Objective To investigate the relationship between persistent hyperglycemia and early stage of acute pancreatitis (AP). Methods A total of 512 cases of AP patients, including 418 cases of light pancreatitis (MAP), severe pancreatitis (SAP) 94 cases. Fasting blood glucose was measured on admission day 2 and day 3 for APACHE II score. On the second day after admission, serum tumor necrosis factor α (TNFα) and C-reactive protein (CRP) were measured. Results The incidence of elevated blood glucose (745%) in SAP patients was significantly higher than that in MAP patients (258%), P = 0001. The APACHEⅡscore of continuous hyperglycemia group was higher than that of non-sustained hyperglycemia group [(13 ± 4) vs (11 ± 3), P = 0017; (13 ± 4) For (11 ± 3), P = 0010; (14 ± 4) vs. (10 ± 4), P = 0010]. Persistent hyperglycemia was associated with grading of SAP severity (χ2 = 777, P = 0005). The levels of serum TNFα [(20 ± 14) vs (14 ± 11), P = 0019] and CRP [(123 ± 81) vs (93 ± 55), P = 0036] in patients with persistent hyperglycemia were significantly higher than those without Hyperglycemia group. Conclusions Persistent hyperglycemia may be a risk factor for early AP exacerbations.