CAJ | 학술논문

目的探讨急性胰腺炎病因与疾病严重程度之间的关系.方法采用回顾性分析方法,收集2012年5月至2014年5月间江苏大学附属人民医院消化内科、普外科及重症医学科收治的急性胰腺炎患者486例,记录患者一般数据,分析患者急性胰腺炎病因,并依照2012年“修订版”亚特兰大标准对急性胰腺炎严重程度进行分层.比较不同性别、年龄组及病因与疾病严重程度的关系.结果 486例患者中病因分布为胆源性296例(60.9％),高脂血症性93例(19.1％),酒精性48例(9.9％),其他原因49例(10.1％);严重程度分布为轻症急性胰腺炎(MAP) 387例(79.6％),中度重症急性胰腺炎(MSAP) 53例(10.9％),重症急性胰腺炎(SAP) 46例(9.5％).在胆源性胰腺炎中女性比例高于男性(1.2∶1.0),但在高脂血症及酒精性胰腺炎中,男性比例明显高于女性(P =0.000).胆源性胰腺炎发病年龄趋于≥40岁人群,而高脂血症性和酒精性胰腺炎则趋向于＜60岁人群(P=0.000).各年龄组MSAP、SAP发生率比较,≥60岁组MSAP发生率最高,为14％,＜40岁组SAP发生率最高,为11.3％,MSAP、SAP总计最高为≥60岁组,22.2％.与胆源性、酒精性及其他原因相比,高脂血症性发生MSAP、SAP的概率更高(P=0.028).结论胆源性因素仍是临床急性胰腺炎的主要病因,但高脂血症性胰腺炎近年来发病概率呈上升趋势,并往往导致更为严重的临床过程,应引起临床医师的重视,并注意加强对患者的健康宣教.
목적 탐토급성이선염병인여질병엄중정도지간적관계.방법 채용회고성분석방법,수집2012년5월지2014년5월간강소대학부속인민의원소화내과、보외과급중증의학과수치적급성이선염환자486례,기록환자일반수거,분석환자급성이선염병인,병의조2012년“수정판”아특란대표준대급성이선염엄중정도진행분층.비교불동성별、년령조급병인여질병엄중정도적관계.결과 486례환자중병인분포위담원성296례(60.9％),고지혈증성93례(19.1％),주정성48례(9.9％),기타원인49례(10.1％);엄중정도분포위경증급성이선염(MAP) 387례(79.6％),중도중증급성이선염(MSAP) 53례(10.9％),중증급성이선염(SAP) 46례(9.5％).재담원성이선염중녀성비례고우남성(1.2∶1.0),단재고지혈증급주정성이선염중,남성비례명현고우녀성(P =0.000).담원성이선염발병년령추우≥40세인군,이고지혈증성화주정성이선염칙추향우＜60세인군(P=0.000).각년령조MSAP、SAP발생솔비교,≥60세조MSAP발생솔최고,위14％,＜40세조SAP발생솔최고,위11.3％,MSAP、SAP총계최고위≥60세조,22.2％.여담원성、주정성급기타원인상비,고지혈증성발생MSAP、SAP적개솔경고(P=0.028).결론 담원성인소잉시림상급성이선염적주요병인,단고지혈증성이선염근년래발병개솔정상승추세,병왕왕도치경위엄중적림상과정,응인기림상의사적중시,병주의가강대환자적건강선교.
Objective To explore the relationship between etiology and severity of acute pancreatitis (AP).Methods A total of 486 AP patients,hospitalized at digestive,general surgery or critical care medicine departments from May 2012 to May 2014,were recruited retrospectively.And the data of clinical features,etiology and severity classification of AP according to the revised Atlanta criteria (2012) were collected.The relationships between different gender,age group,etiology and severity of disease were compared.Results The etiology distribution was as follows:gallstone (n =296,60.9％),hyperlipidemia (n=93,19.1％),alcohol (n=48,9.9％) and other causes (n =49,10.1％).And the severity was mild AP (MAP,n =387,79.6％),moderate-severe AP (MSAP,n =53,10.9％) and severe AP (SAP,n =46,9.5％).The proportion of females for gallstone AP was slightly higher than that of males(1.23:1).However,for hyperlipidemic and alcoholic AP,the proportion of males was significantly higher than that of females (P =0.00).The onset age of gallstone AP was generally over 40 years while hyperlipidemic and alcoholic AP tended to occur in patients aged under 60 years (P =0.00).Among all age groups,the group of over 60 years had the highest MSAP incidence of 14％ while ＜40-year-old group the highest incidence of SAP at 11.3％.And the ＞60-year-old group had the highest total incidence of MSAP and SAP at 22.2％.Compared with gallstone,alcohol and other causes,hyperlipidemic AP had a higher risk of MSAP and SAP (P =0.028).Conclusion Gallstone remains a leading cause of AP.Hyperlipidemic pancreatitis has shown a rising tendency in recent years and it often result in a more serious clinical process.And the clinicians should pay more attention to health education of patients.