高脂血症性急性胰腺炎死亡病例临床特点分析

摘要

Objective To investigate the clinical feature of death cases of hyperlipidemic acute pancreatitis( HLAP) ,to discuss the correlative risk factors of death of HLAP. Methods The clinical data of eighty-six patients with HLAP were analyzed retrospectively. All the patients were divided into the death group and the survival group. Basic information, laboratory data, Ranson score,acute physiology and chronic health evaluation( APACHE) score,and computed tomography severity index were compared between two groups. Results There was no statistical significance in age, sexuality, adiposis hepatica, blood amylase,urine amylase, triglyceride and base excess between two groups(P >0. 05 ). Compared with the survival group, the case history was shorter obviously( P < 0. 05) ,the ratio of patients with diabetes was higher( P < 0. 05) , the body mass index and blood glucose increased significantly (P <0.05) ,but the level of blood calcium was lower in the death group(P <0. 05). The Ranson score and APACHE score in the death group were significantly higher than those in the survival group(P <0. 05) , but there was no significant difference in the CTSI between two groups(P>0. 05). Conclusion The young and middle-aged groups are proned to HLAP,the death time is more concentrated in the early stage of acute pancreatitis,multiple organ failure is the main cause of death. Uncontrolled serum glucose and blood calcium may be the risk factors of death in patients with HLAP.%目的 分析高脂血症性急性胰腺炎死亡病例的临床特点,探讨与高脂血症性急性胰腺炎死亡相关的危险因素.方法 回顾性分析86例高脂血症性急性胰腺炎患者的临床资料,根据是否死亡分为死亡组和生存组,比较2组患者的基本资料、实验室资料、Ranson评分、急性生理与慢性健康评分(APACHE)及计算机断层扫描严重指数(CTSI)等方面的差异.结果 死亡组和生存组在年龄、性别、合并脂肪肝病史比例、血尿淀粉酶、三酰甘油、剩余碱等方面比较差异无统计学意义(P＞0.05).与生存组比较,死亡组病史明显缩短(P＜0.05),合并糖尿病病史比例明显升高(P＜0.05),体质量指数、血糖明显升高(P＜0.05),血钙明显降低(P＜0.05).死亡组Ranson评分、APACHE评分明显高于生存组(P＜0.05);2组间CTSI比较差异无统计学意义(P＞0.05).结论 高脂血症性急性胰腺炎好发于中青年男性,死亡时间多集中在胰腺炎发病早期,死亡原因多为多器官衰竭,不可控制的血糖和血钙可能是预示高脂血症性急性胰腺炎死亡的危险因素.