Clinical significance of serum triglyceride elevation at early stage of acute biliary pancreatitis.
Clinical significance of serum triglyceride elevation at early stage of acute biliary pancreatitis.
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急性胆源性胰腺炎早期血清甘油三酯升高的临床意义
DOI：
10.1186/s12876-015-0254-x
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发表时间：
2015-02-14
影响因子：
2.4
通讯作者：
Tian F
中科院分区：
文献类型：
--
作者：
Cheng L;Luo Z;Xiang K;Ren J;Huang Z;Tang L;Tian F
高甘油三酯血症(HTG)所致的胰腺炎已引起广泛关注。然而，非常有限的研究集中在非HTG诱导的胰腺炎，如急性胆源性胰腺炎(ABP)中甘油三酯升高的临床意义。本研究旨在探讨ABP患者甘油三酯(TG)升高的临床意义。我们对本研究中心收治的426例ABP病例进行了回顾性分析。根据发病72小时内最高甘油三酯水平，将患者分为甘油三酯正常组和甘油三酯增高组。分析两组患者一般情况、疾病严重程度、APACHE II评分、Ranson评分、炎症细胞因子、并发症及预后等方面的差异。与正常甘油三酯组相比，甘油三酯增高组患者的体重指数明显升高，且明显年轻化。ABP早期的TG升高与重症胰腺炎和器官衰竭，特别是呼吸衰竭的风险较高相关。对于重症胰腺炎患者，甘油三酯水平升高的患者更有可能有更大的坏死面积，更高的胰腺脓肿发生率和更高的死亡率(17.78%比9.80%，P <； 0.05)。在ABP患者中，TG升高可能参与胰腺炎的加重和全身或局部并发症的发生。因此，TG水平可作为判断ABP患者预后的重要指标。
Pancreatitis induced by hypertriglyceridemia (HTG) has gained much attention. However, very limited numbers of studies have focused on the clinical significance of TG elevation in non-HTG induced pancreatitis, such as acute biliary pancreatitis (ABP). This study aimed to study the clinical significances of triglyceride (TG) elevation in patients with ABP. We retrospectively analyzed a total of 426 ABP cases in our research center. According to the highest TG level within 72 h of disease onset, the patients were divided into a normal TG group and an elevated TG group. We analyzed the differences between the two groups of patients in aspects such as general information, disease severity, APACHE II (acute physiology and chronic health evaluation II) and Ranson scores, inflammatory cytokines, complications and prognosis. Compared with the normal TG group, patients in the elevated TG group showed a significantly higher body mass index and were significantly younger. TG elevation at the early stage of ABP was associated with higher risk of severe pancreatitis and organ failures, especially respiratory failure. For patients with severe pancreatitis, those with elevated TG levels were more likely to have a larger area of necrosis, and higher incidence of pancreatic abscess as well as higher mortality (17.78% versus 9.80%, P < 0.05). In ABP patients, TG elevation might participate in the aggravation of pancreatitis and the occurrence of systemic or local complications. Thus, the TG level may serve as an important indicator to determine the prognosis of patients with ABP.
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