急性重症胰腺炎患者血脂水平变化及预后不良的危险因素分析

摘要

Objective To investigate the changes in serum lipid levels and the risk factors for poor prognosis in patients with severe acute pancreatitis .Methods A retrospective analysis was conducted in 100 patients with acute severe pancreatitis ( survival 87 cases and 13 cases died ) , the serum lipid level on the first day after admission was tested .The clinical data of survival group and death group were analyzed to explore the risk factors for poor prognosis in patients with acute severe pancreatitis .Results There was no significant difference in gender and CT score between two groups(P>0.05).The age,APACHEⅡ score,Ranson score and duration in the survival group were significantly smaller or less than those in the death group (P<0.05).On the second day after admission ,TC and TG in the survival group were significantly lower than those in the death group ( P<0 .05 ) ,whereas HDL ,LDL showed no significant difference between two groups (P>0.05).Unconditional logistic regression analysis showed that age ,high TG levels,high APACHEⅡscore were independent risk factors for severe acute pancreatitis patients with poor prognosis (P<0.05).Conclusion Age,high TG levels,high APACHE Ⅱ score are independent risk factor for severe acute pancreatitis patients with poor prognosis .%目的：探讨急性重症胰腺炎患者血脂水平变化及预后不良的危险因素。方法对100例急性重症胰腺炎患者（存活87例，死亡13例）的临床资料进行回顾性分析，测定患者入院后第1天血脂水平。对比分析存活组和死亡组的临床资料，探讨急性重症胰腺炎患者预后不良的危险因素。结果两组性别、CT评分比较，差异无统计学意义（ P＞0．05）。存活组年龄、APACHEⅡ评分、Ranson评分、病程均明显小于或低于死亡组（ P＜0．05）。存活组入院后次日TC、TG均明显低于死亡组（ P＜0．05），而HDL、LDL 差异无统计学意义（ P＞0．05）。非条件logistic回归分析结果显示，年龄大、TG水平高、APACHEⅡ评分高是急性重症胰腺炎患者预后不良的独立危险因素（ P＜0．05）。结论年龄大、TG水平高、APACHEⅡ评分高是急性重症胰腺炎患者预后不良的独立危险因素。