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目的探讨影响急性胰腺炎(AP)早期病情严重程度及预后的因素。方法确诊AP 286例,根据CT分级分为轻症与重症两组,分析年龄、性别、病因及发病48 h内患者血氧分压、血清电解质、空腹血糖、C反应蛋白(CRP)、血淀粉酶变化与胰腺CT分级比较,判定影响AP早期病情严重程度的指标。结果两组性别相比较χ2=0.086,P>0.05,差异不显著;两组年龄相比较。重症组高于轻症组,t=2.023P<0.05;病因相比较,胆源性、高脂血症其他因素,χ2分别为0.158、3.240、0.085,P>0.05,差异不显著。但暴饮暴食在轻症组高于重症组,χ2=5.690,P<0.05,差异显著。平均血氧分压t=11.699,P<0.05,差异显著。血电解质相比较Ca2+t=4.604,P<0.05,差异显著,Cl-t=3.271,P<0.05,差异显著,K+t=0.780,P>0.05,差异不显著,Na+t=1.830,P>0.05,差异不显著;空腹血糖t=-4.582,P<0.05,差异显著;血淀粉酶t=0.693,P>0.05,差异不显著:血CRPt=-5.620,P<0.05,差异显著。结论年龄、CRP、血糖、血钙、血氧分压可以作为AP早期判断患者轻重及预后的因素,对病情早期预测,指导临床治疗有实际参考价值。
Objective To explore the factors affecting the severity and prognosis of early stage of acute pancreatitis (AP). Methods A total of 286 AP patients were diagnosed. According to CT classification, the patients were divided into two groups: mild and severe. The patients were divided into two groups according to their age, sex, etiology and intra-arterial pressure, serum electrolytes, fasting plasma glucose, C-reactive protein Enzyme changes and pancreatic CT grade comparison determine the severity of early AP disease indicators. Results There was no significant difference in gender between the two groups (χ2 = 0.086, P> 0.05). The two groups were compared in age. The severe group was higher than the mild group, t = 2.023P <0.05; compared with the etiology, biliary, hyperlipidemia other factors, χ2 were 0.158,3.240,0.085, P> 0.05, the difference was not significant. However, binge eating in the mild group than in the severe group, χ2 = 5.690, P <0.05, the difference was significant. The average partial pressure of oxygen t = 11.699, P <0.05, significant difference. Blood electrolytes compared with Ca2 + t = 4.604, P <0.05, the difference was significant, Cl-t = 3.271, P <0.05, the difference was significant, K + t = 0.780, P> 0.05, P> 0.05, the difference was not significant; fasting blood glucose t = -4.582, P <0.05 significant difference; blood amylase t = 0.693, P> 0.05, the difference was not significant: blood CRPt = -5.620, P <0.05 significant difference. Conclusion Age, CRP, blood glucose, blood calcium, blood oxygen partial pressure can be used as the early AP judging factors of patients’ severity and prognosis, and have practical reference values for early prognosis and clinical treatment.