中华胰腺病杂志
中華胰腺病雜誌
중화이선병잡지
CHINESE JOURNAL OF PANCREATOLOGY
2014年
1期
16-20
,共5页
黄耀星%贾林%聂玉强%江舒曼%欧娅
黃耀星%賈林%聶玉彊%江舒曼%歐婭
황요성%가림%섭옥강%강서만%구아
胰腺炎%高三酰甘油血症%发病率%疾病特征%回顾性研究
胰腺炎%高三酰甘油血癥%髮病率%疾病特徵%迴顧性研究
이선염%고삼선감유혈증%발병솔%질병특정%회고성연구
Pancreatitis%Hypertriglyceridemia%Incidence%Disease attributes%Retrospective studies
目的 回顾性分析近20年广州市第一人民医院收治的高三酰甘油血症性急性胰腺炎(HLAP)的发病率及其临床特征变化.方法 收集1991年1月至2010年12月广州医科大学附属广州市第一人民医院急性胰腺炎(AP)病例1 362例,根据时间划分为4个年度段(1991年至1995年,1996年至2000年,2001年至2005年,2006年至2010年),比较HLAP患者的发病构成、临床特征和预后.结果 HLAP患者共99例,其中男性61例,女性38例,平均年龄(44±12)岁,以年轻男性居多.HLAP患者占总AP患者的7.3％,4个年度构成比分别为5.4％、5.7％、6.7％和8.3％,20年间增加了1.5倍.99例HLAP患者平均血淀粉酶活性为(513.3±462.7) mmol/L,TG为(12.7±7.0) mmol/L,Ranson评分为(1.2±1.1)分,CT严重指数(CTSI)为(2.2±1.1)分,全身炎症反应综合征(SIRS)发生率为36.4％,脏器功能衰竭发生率为18.2％,胰腺假性囊肿发生率5.1％,但重度急性胰腺炎(SAP)发生率和病死率并不随年代变迁而变化.HLAP患者SAP发生率和病死率均显著高于胆源性AP(分别为20.2％比8.5％,6.1％比2.8％).血液净化应用率从第1年度段的0上升到第4年度段的10.7％.HLAP患者的住院时间从第1年度段的26 d逐渐下降至第4年度段的14 d,差异具有统计学意义(P＜0.05).结论 HLAP发生率呈逐年升高趋势,有重症化倾向,但患者预后有所改善.
目的 迴顧性分析近20年廣州市第一人民醫院收治的高三酰甘油血癥性急性胰腺炎(HLAP)的髮病率及其臨床特徵變化.方法 收集1991年1月至2010年12月廣州醫科大學附屬廣州市第一人民醫院急性胰腺炎(AP)病例1 362例,根據時間劃分為4箇年度段(1991年至1995年,1996年至2000年,2001年至2005年,2006年至2010年),比較HLAP患者的髮病構成、臨床特徵和預後.結果 HLAP患者共99例,其中男性61例,女性38例,平均年齡(44±12)歲,以年輕男性居多.HLAP患者佔總AP患者的7.3％,4箇年度構成比分彆為5.4％、5.7％、6.7％和8.3％,20年間增加瞭1.5倍.99例HLAP患者平均血澱粉酶活性為(513.3±462.7) mmol/L,TG為(12.7±7.0) mmol/L,Ranson評分為(1.2±1.1)分,CT嚴重指數(CTSI)為(2.2±1.1)分,全身炎癥反應綜閤徵(SIRS)髮生率為36.4％,髒器功能衰竭髮生率為18.2％,胰腺假性囊腫髮生率5.1％,但重度急性胰腺炎(SAP)髮生率和病死率併不隨年代變遷而變化.HLAP患者SAP髮生率和病死率均顯著高于膽源性AP(分彆為20.2％比8.5％,6.1％比2.8％).血液淨化應用率從第1年度段的0上升到第4年度段的10.7％.HLAP患者的住院時間從第1年度段的26 d逐漸下降至第4年度段的14 d,差異具有統計學意義(P＜0.05).結論 HLAP髮生率呈逐年升高趨勢,有重癥化傾嚮,但患者預後有所改善.
목적 회고성분석근20년엄주시제일인민의원수치적고삼선감유혈증성급성이선염(HLAP)적발병솔급기림상특정변화.방법 수집1991년1월지2010년12월엄주의과대학부속엄주시제일인민의원급성이선염(AP)병례1 362례,근거시간화분위4개년도단(1991년지1995년,1996년지2000년,2001년지2005년,2006년지2010년),비교HLAP환자적발병구성、림상특정화예후.결과 HLAP환자공99례,기중남성61례,녀성38례,평균년령(44±12)세,이년경남성거다.HLAP환자점총AP환자적7.3％,4개년도구성비분별위5.4％、5.7％、6.7％화8.3％,20년간증가료1.5배.99례HLAP환자평균혈정분매활성위(513.3±462.7) mmol/L,TG위(12.7±7.0) mmol/L,Ranson평분위(1.2±1.1)분,CT엄중지수(CTSI)위(2.2±1.1)분,전신염증반응종합정(SIRS)발생솔위36.4％,장기공능쇠갈발생솔위18.2％,이선가성낭종발생솔5.1％,단중도급성이선염(SAP)발생솔화병사솔병불수년대변천이변화.HLAP환자SAP발생솔화병사솔균현저고우담원성AP(분별위20.2％비8.5％,6.1％비2.8％).혈액정화응용솔종제1년도단적0상승도제4년도단적10.7％.HLAP환자적주원시간종제1년도단적26 d축점하강지제4년도단적14 d,차이구유통계학의의(P＜0.05).결론 HLAP발생솔정축년승고추세,유중증화경향,단환자예후유소개선.
Objective To retrospectively investigate the clinical features and incidence trends of hypertriglyceridemic acute pancreatitis (HLAP) in Guangzhou First People's Hospital for 20 years.Methods The medical records of 1 362 patients,who were admitted to Guangzhou First People's Hospital with acute pancreatitis during January 1991 to December 2010,were reviewed and 99 patients met the HLAP criterion.These patients were divided into four groups according to years (1991 ～ 1995,1996 ～2000,2001 ～2005,and 2006 ～2010).The incidence and clinical features were compared among the 4 groups.Results Among the 99 patients,there were 61 males and 38 females,the mean age was (44 ± 12) years old,and young male was predominant in HLAP.HLAP accounted for 7.3％ of all AP patients,and the incidence was increased 1.5 times during the 20 years period (5.4％,5.7％,6.7％,and 8.3％ respectively).The serum amylase level was (513.3 ±462.7) mmol/L,TG level was (12.7 ± 7.0) mmol/L,Ranson score was (1.2 ± 1.1),CTSI score was 2.2 ± 1.1,incidence of SIRS was 36.4％,and the incidence of MODS was 18.2％,and the incidence of pancreatic pseudocyst was 5.1％,but the incidence and mortality of SAP was not changed with time.The incidence and mortality of SAP of HLAP were significantly higher than those of acute biliary pancreatitis (20.2％ vs 8.5％,6.1％ vs 2.8％).The rate of blood purification increased from 0 to 10.7％,and the hospital stay was decreased from 26 d to 14 d,and the difference between the two groups was statistically significant (P ＜ 0.05).Conclusions Incidence of HLAP is increased gradually,with a trend towards more severe disease,but the prognosis is improved.
