摘要
目的探讨青年急性胰腺炎患者的病因构成、病情程度及相关临床特点。方法回顾性分析武汉大学人民医院2006年1月至2009年12月423例急性胰腺炎，收集所有年龄≤34岁的55例作为青年组，并随机选取同期55例年龄〉34岁的病例作为中老年组，分别观察其病因构成，根据不同评分标准评估其病情，并分析相应临床特点。结果青年组病因构成与中老年组有明显差异（χ^2=17．107，P=0．009），青年组以胆源性和特发性急性胰腺炎为主，而中老年组以胆源性和酒精性为主。青年组饮食相关急性胰腺炎及特发性急性胰腺炎发病率高于中老年组（χ^2=4．853，P=0．028；χ^2=4．274，P=0．039）。青年组急性生理学与慢性健康评价Ⅱ、Ranson、严重程度床边指数三种评分均明显低于中老年组（t=5．381，P=0．000；t=4．388，P=0．000及t=3．083，P=0．003），但CT严重指数评分两组间差异无统计学意义（t=-0．750，P〉0．05）。青年组既往有急性胰腺炎发作史者少于中老年组（χ^2=4．251，P=0．039），合并症主要为胆囊炎，合并妊娠患者多于中老年组（χ^2=4．151，P=0．042），而并发血糖升高者少于中老年组（χ^2=13．285，P=0．000）。结论青年急性胰腺炎病因较分散，饮食因素所致的比例相对较高，全身并发症发生率和死亡风险低于中老年组，而局部并发症发生率及病情严重程度与中老年组元明显差异。
Objective To investigate etiology and clinical features of acute pancreatitis （AP） in young patients. Methods In total, 423 patients with AP admitted to Renmin Hospital of Wuhan University, Wuhan, Hubei province during January 2006 to December 2009 were retrospectively analyzed, 55 cases aged 34 years or less as young group and another 55 cases aged more than 34 years as middle- and elderly-age group. Their etiology, clinical features and illness scores based on some standard criteria were assessed. Results Proportion of varied etiologies of AP in young group was different from that in middle- and elderlyage one （ χ^2 = 17. 107, P = 0. 009 ）, mainly as biliary and idiopathic panereatitis in young group and as biliary and alcoholic pancreatitis in middle- and elderly-age one. Incidence of diet-related and idiopathic panereatitis were higher in young group than that in middle- and elderly-age one （χ^2 = 4. 853, P = 0. 028 and χ^2 = 4. 274, P = 0. 039 ）. Scores of the acute physiology and chronic health evaluation Ⅱ （ APACHE Ⅱ） , Ranson criteria and the bedside index for severity in acute pancreatitis （BISAP） were all lower in young group than those in middle- and elderly-age one （t =5. 381, P =0. 000; t =4. 388, P =0. 000 and t = 3. 083, P = 0. 003 ）. There was no statistically significant difference in scores of computed tomography severity index （CTSI） between young group and middle- and elderly-age one （ t = - 0. 750, P 〉 0. 05 ）. Recurrence rate of AP was lower in young group than that in middle- and elderly-age one （ χ^2 = 4. 251, P = 0. 039）. Choleeystitis was more complicated in young group, pregnancy was more complicated in young group （χ^2 =4. 151, P =0. 042） , and elevated blood glucose was more complicated in middle- and elderly- age one （ χ^2 = 13.285, P = 0. 000 ）. Conclusions Etiology of AP varies in young patients with more dietary factors, occurrence of systemic complications and risks for death are lower in young group than those in middle- and elderly-age one, and there was no statistically significant difference in local complications and severity of illness between the two groups.
出处
《中华全科医师杂志》
2011年第5期320-323,共4页
Chinese Journal of General Practitioners
关键词
青年期
胰腺炎
回顾性分析
Youth
Pancreatitis
Retrospective studies
