摘要
目的 探讨急性胰腺炎严重程度与血脂代谢异常的相关性及其预后.方法 选择急性胰腺炎患者128例,并根据严重程度将128例患者分为轻症急性胰腺炎（MAP）组80例,重症急性胰腺炎（SAP）组48例.比较两组患者的性别、年龄、体质量指数（BMI）以及糖尿病、酗酒的比例,观察两组患者血脂水平,分析血脂水平与急性胰腺炎严重度的相关性,并比较两组患者的预后.结果 SAP组男性患者比例明显高于MAP组,两组患者BMI均高于对照组,且SAP组BMI明显高于MAP组（P＜0.05）;SAP组伴有糖尿病、有酗酒史的比例明显高于MAP组（P＜0.05）.MAP组、SAP组患者血清三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）均明显高于对照组（P＜0.05）,两组患者血清高密度脂蛋白胆固醇（HDL-C）则明显低于对照组;SAP组患者TG、LDL-C明显高于MAP组,HDL-C则明显低于MAP组（P＜0.05）.急性胰腺炎患者APACHE Ⅱ评分与TG、LDL-C呈正相关,与HDL-C呈负相关（P＜0.05）.SAP组患者的感染、脓肿、坏死、假性囊肿、急性肺损伤或ARDS发生率明显高于MAP组（P＜0.05）.结论 急性胰腺炎的严重程度与脂代谢异常有一定的相关性,两者相互影响;脂代谢异常程度也影响着急性胰腺炎的预后.治疗急性胰腺炎时应在积极控制胰腺炎症的同时降低血脂水平,防止和减少胰腺坏死.
Objective To investigate the correlation between severity or prognosis of acute pan- creatitis and abnormal lipid metabolism. Methods 128 patients with acute pancreatitis were selected, and divided into MAP group（ 80 subjects） and SAP group（ 48 subjects） according to severity. The ratio of gender, age, BMI, diabetes, alcoholism in two groups were compared. The blood lipid levels in two groups were examined and the correlation between blood lipid levels and the severity were analyzed. The prognosis of two AP group were compared. Results The ratio of male in SAP group was higher than that in MAP group. The BMI of AP petients were higher than control group, while the BMI of SAP group was higher than that in MAP group（ P 〈 0.05 ）. Moreover, the percentage of diabetes mellitus and history of alcohol- ism in SAP group were higher than those in MAP group （ P 〈 0.05 ）. The serum TG, LDL-C of MAP and SAP were significantly higher than those in control group（ P 〈 0.05 ） ,while the serum HDL-C of patients in AP patients were significantly lower than that of control group. The TG and LDL-C of SAP group were higher than those in MAP group, while HDL-C was significantly lower than that in MAP group （ P 〈 0.05）. The AP APACHE II score of patients were positively correlated with TG and LDL-C, while nega- tively correlated with HDL-C （ P 〈 0.05 ）. Infection, abscess, pseudocyst, necrosis and acute lung injury or the incidence of ARDS of SAP Group were higher than those in MAP group （ P 〈 0.05 ）. Conclusion The severity of abnormal lipid metabolism and AP is correlated and may have a causal relationship. The disor- dered lipid metabolism has a negative effect on the AP prognosis. Therefore, active lipid management and inflammation neutralization to prevent the pancreatic necrosis and improve the prognosis are crucial in treatment of AP.
出处
《临床内科杂志》
CAS
2014年第3期183-185,共3页
Journal of Clinical Internal Medicine
关键词
急性胰腺炎
血脂代谢异常
体质量指数
Acute pancreafitis
Abnormal lipid metabolism
Body mass index
