摘要
目的:探讨急性胰腺炎(AP)合并2型糖尿病患者临床特征及其发生重症胰腺炎的危险因素。方法:回顾性选择2021年1月—2022年12月靖江市人民医院消化内科收治的急性胰腺炎合并2型糖尿病患者100例作为研究组,单纯急性胰腺炎患者40例作为对照组,记录统计两组临床特征资料,包括年龄、性别、体重指数(BMI)、症状、是否合并高脂血症、是否合并脂肪肝及是否合并胆结石。根据患者是否发生重症胰腺炎将急性胰腺炎合并2型糖尿病患者分为重症组及非重症组,统计比较两组患者年龄、性别、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、降钙素原(PCT)、C反应蛋白(CRP)、白蛋白(ALB)、血钙(Ca)、血淀粉酶(AMY)、中性粒细胞与淋巴细胞比率(NLR)及血小板与淋巴细胞比值(PLR),多因素logistic回归分析对发生重症胰腺炎的危险因素进行分析。结果:研究组年龄小于对照组,BMI高于对照组,合并高脂血症、脂肪肝比例高于对照组,差异均有统计学意义(P<0.05)。两组性别、腹痛、恶心呕吐、合并胆结石率差异均无统计学意义(P>0.05)。AP合并2型糖尿病患者中21例发生重症胰腺炎。重症组HbA1c、PCT、CRP>200 mg/L患者比例、NLR及PLR均高于非重症组,而ALB及Ca低于非重症组,差异均有统计学意义(P<0.05)。两组年龄、性别、TC、TG、HDL-C、LDL-C、AMY差异均无统计学意义(P>0.05)。多因素logistic回归分析表明,HbA1c、NLR及PLR为AP合并2型糖尿病患者发生重症胰腺炎的危险因素(P<0.05)。结论:合并2型糖尿病的AP患者年龄较小,体型较胖,易并发高脂血症、脂肪肝;高HbA1c、NLR及PLR易致重症胰腺炎的发生,临床应早期识别干预。
Objective:To investigate the clinical characteristics of acute pancreatitis(AP)patients with type 2 diabetes and the risk factors for severe pancreatitis.Method:A total of 100 patients with acute pancreatitis combined with type 2 diabetes admitted to the Department of Gastroenterology of Jingjiang People's Hospital from January 2021 to December 2022 were retrospectively selected as the study group,and 40 patients with simple acute pancreatitis were selected as the control group.The clinical characteristics of the patients in the two groups were recorded and counted,including age,gender,body mass index(BMI),symptoms,whether combined with hyperlipidemia,fatty liver and gallstones.The patients with acute pancreatitis complicated with type 2 diabetes were divided into severe group and non-severe group according to whether they had severe pancreatitis.The age,gender,glycosylated hemoglobin(HbA1c),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),procalcitonin(PCT),C reactive protein(CRP),albumin(ALB),blood calcium(Ca),blood amylase(AMY),neutrophil to lymphocyte ratio(NLR),and platelet to lymphocyte ratio(PLR)were analyzed.Multivariate logistic regression analysis was used to analyze the risk factors for severe pancreatitis.Result:The age of the study group was less than that of the control group,and the BMI was higher than that of the control group,the proportions of patients with hyperlipidemia and fatty liver were higher than those of the control group,the differences were statistically significant(P<0.05).There were no significant differences between the two groups in gender,abdominal pain,nausea and vomiting,and the rate of gallstones(P>0.05).Severe pancreatitis occurred in 21 cases of AP patients with type 2 diabetes.The HbA1c,PCT,proportion of CRP>200 mg/L patients,NLR,and PLR in the severe group were higher than those in the non-severe group,while ALB and Ca were lower than those in the non-severe group,the differences were statistically significant(P<0.05).There were no significant differences in age,gender,TC,TG,HDL-C,LDL-C,and AMY between the two groups(P>0.05).Multivariate logistic regression analysis showed that HbA1c,NLR and PLR were risk factors for severe pancreatitis in AP patients with type 2 diabetes(P<0.05).Conclusion:AP patients with type 2 diabetes are younger,fatter,and prone to hyperlipidemia and fatty liver.High HbA1c,NLR,and PLR are prone to severe pancreatitis,and early identification and intervention should be recommended in clinical practice.
作者
陈蕾
CHEN Lei(Jingjiang People's Hospital,Jiangsu Province,Jingjiang 214500,China)
出处
《中国医学创新》
CAS
2023年第19期160-164,共5页
Medical Innovation of China
