Impact of Hypertriglyceridemia on the Outcome of Acute Biliary Pancreatitis
Impact of Hypertriglyceridemia on the Outcome of Acute Biliary Pancreatitis
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高甘油三酯血症对急性胆源性胰腺炎预后的影响
DOI：
10.1097/maj.0000000000000333
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发表时间：
2014-11-01
影响因子：
3.1
通讯作者：
Wang, Xingpeng
中科院分区：
文献类型：
--
作者：
Zeng, Yue;Zhang, Wei;Wang, Xingpeng
背景：高脂血症（HTG）是公认的急性胰腺炎（AP）的原因。然而，HTG在调节疾病过程中的作用仍有待明确。我们旨在探讨HTG对急性胆源性胰腺炎（ABP）结局的影响。方法：90例ABP合并HTG患者按改良Atlanta分级分为轻度AP、中重度AP（MSAP）和重度AP（SAP）3组。根据国家胆固醇教育计划（NCEP），根据甘油三酯（TG）水平将患者分为I、II和III型HTG组。记录并分析病情严重程度、兰森评分及并发症。Logistic回归分析筛选严重结局的预测危险因素。结果：在合并HTG的ABP患者中，SAP 23例，MSAP 41例，轻度AP 26例。各组间肥胖、血浆TG水平及兰森评分差异有统计学意义。在伴有II型和III型HTG的ABP患者中，发生MSAP的风险增加。同样地，患有III型HTG的ABP患者发生SAP的风险也增加。Ⅲ型高脂血症组的全身并发症，尤其是呼吸衰竭和局部并发症的发生率明显高于血脂正常组。结论：高TG（≥2.26 mmol/L或200.11 mg/mL）可能是严重ABP的危险因素，并可能导致全身和局部并发症的发生。
Background:Hypertriglyceridemia (HTG) is a well-recognized cause of acute pancreatitis (AP). However, the role of HTG in modulating disease course remains to be cleared. We aimed to explore the impact of HTG on the outcome of acute biliary pancreatitis (ABP). Methods:A total of 90 ABP patients with HTG were enrolled in this study and were divided into 3 groups based on ABP severity: mild AP, moderately severe AP (MSAP) and severe AP (SAP), according to the modified Atlanta classification. Besides, patients were divided into type I, II and III HTG groups based on the triglyceride (TG) level, according to the national cholesterol education program (NCEP). Disease severity, Ranson score and complications were recorded and analyzed. Logistic regression analysis was performed to screen predictive risk factors of severe outcomes. Results:There were 23 patients with SAP, 41 with MSAP and 26 with mild AP among the ABP patients with HTG. Significant differences were observed in the obesity, plasma TG level and Ranson score among groups. The risk of developing MSAP in ABP patients with type II and III HTG was increased. Similarly, the risk of developing SAP in ABP patients with type III HTG was also enhanced. The incidence of systemic, especially respiratory failure, and local complications in type III HTG group were significantly higher than normal lipid group. Conclusions:High TG level (≥2.26 mmol/L or 200.11 mg/mL) may be a risk factor for severe ABP and the development of systemic and local complications in ABP.