摘要
目的探讨复发性高甘油三酯血症性急性胰腺炎(recurrent hypertriglyceridemic acute pancreatitis,RHTG-AP)的临床特点,分析RHTG-AP患者重症化的危险因素。方法回顾性收集2012年1月至2023年3月于广西医科大学第一附属医院确诊为HTG-AP的255例患者的临床资料,根据有无复发情况将其分为初发组和复发组,再将复发组患者分为N-SAP组和SAP组。分析RHTG-AP的临床特点,多因素Logistic回归分析RHTG-AP重症化的独立危险因素,绘制ROC曲线,评估独立危险因素的预测效能。结果复发组在急性坏死物聚集、胸腔积液、腹腔积液、呼吸衰竭、肾衰竭、多器官功能障碍、严重程度、入住ICU方面显著低于初发组(P<0.05),年龄、糖尿病史显著高于初发组(P<0.05)。LYM、Ca^(2+)、ALB、K^(+)、Cr、BUN、AST与RHTG-AP患者SAP的发生显著相关(P<0.05),Cr和ALB是发生SAP的独立危险因素。Cr、ALB、Cr+ALB预测RHTG-AP患者SAP的AUC分别为0.719、0.890、0.952。结论RHTG-AP患者较初发患者病情严重程度轻,Cr、ALB是RHTG-AP重症化的独立危险因素,Cr+ALB对RHTG-AP患者病情严重程度具有更好的预测价值。
Objective To investigate the clinical characteristics of recurrent hypertriglyceridemic acute pancreatitis(RHTG-AP)and analyze the risk factors for severe progression in RHTG-AP patients.Methods The clinical data of 255 patients diagnosed with HTG-AP at the First Affiliated Hospital of Guangxi Medical University from Jan.2012 to Mar.2023 were retrospectively collected.These patients were divided into the primary group and the recurrent group based on the presence or absence of recurrence,and the recurrent group was further divided into the N-SAP group and SAP group.The clinical characteristics of RHTG-AP were analyzed,and independent risk factors for the severe progression of RHTG-AP were assesed using Logistic regression analysis,ROC curves were plotted to evaluate the predictive performance of independent risk factors.Results In the recurrent group,the occurrence of acute necrotizing collections,pleural effusion,abdominal effusion,respiratory failure,renal failure,multiple organ dysfunction,and severity of illness requiring ICU admission were significantly lower than those in the primary group(P<0.05).However,the prevalence of diabetes mellitus history and age were significantly higher in the recurrent group compared to the primary group(P<0.05).LYM,Ca^(2+),ALB,K^(+),Cr,BUN,AST were significantly associated with the occurrence of SAP in RHTG-AP patients(P<0.05).Cr and ALB were identified as independent risk factors for SAP occurrence.The AUC for predicting SAP in RHTG-AP patients using Cr,ALB and their combination were 0.719,0.890 and 0.952,respectively.Conclusion Compared to primary patients,RHTG-AP patients tend to have less severe conditions.Cr and ALB are identified as independent risk factors for the severe progression of RHTG-AP.The combination of Cr and ALB provides better predictive value for the severity of illness in RHTG-AP patients.
作者
赵梓粤
符振华
梁耀冰
李美乐
程冬瑀
罗剑明
姜海行
覃山羽
ZHAO Ziyue;FU Zhenhua;LIANG Yaobing;LI Meile;CHENG Dongyu;LUO Jianming;JIANG Haixing;QIN Shanyu(Department of Gastroenterology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021;Department of Experimental Research,the Affiliated Tumor Hospital of Guangxi Medical University,China)
出处
《胃肠病学和肝病学杂志》
2025年第7期1048-1052,共5页
Chinese Journal of Gastroenterology and Hepatology
基金
国家自然科学基金地区科学基金项目(82260539)
广西自然科学基金项目(2024GXNSFAA010072)。
关键词
高甘油三酯血症性急性胰腺炎
临床特点
危险因素
Hypertriglyceridemic acute pancreatitis
Clinical characteristics
Risk factors
