Coagulopathy and the prognostic potential of D-dimer in hyperlipidemia-induced acute pancreatitis

摘要

BACKGROUND: Coagulopathy and its association with disease severity in hyperlipidemia(HL)- and non-hyperlipidemia(NHL)-induced acute pancreatitis(AP) are not clear. The present study was to evaluate the relationship between coagulation homeostasis and AP.METHODS: This study included 106 AP patients admitted to our hospital between October 2011 and January 2013. Stratified by disease severity,the patients were divided into two groups: a mild AP(MAP) group(n=69); and a moderately severe AP(MSAP) group(n=37). Based on disease etiology,there were 31 HL-induced AP(HLP) cases and 75 NHL-induced AP(NHLP) cases. The HLP and NHLP groups were compared for parameters of coagulation homeostasis,lipid metabolism,and disease severity. Correlations between disease severity and levels of D-dimer and protein C were investigated,and the prognostic potential of D-dimer was evaluated.RESULTS: Compared with MAP patients,MSAP patients showed higher levels of D-dimer and lower levels of protein C. HLP patients had higher protein C levels than NHLP patients. Both D-dimer and protein C levels were significantly associated with the disease severity,not the disease etiology. D-dimer levels correlated positively with low density lipoprotein cholesterol levels and performed well as a sensitive and specific predictor of disease severity in AP patients,especially in HLP patients.CONCLUSIONS: The coagulation homeostasis is different between HLP and NHLP patients,and HL may be a contributingfactor for thrombosis and fibrinolysis in HLP. D-dimer may be a robust marker of disease severity in HLP.