Acute pancreatitis associated with severe hypertriglyceridaemia; A retrospective cohort study
Acute pancreatitis associated with severe hypertriglyceridaemia; A retrospective cohort study
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DOI：
10.1016/j.ijsu.2015.08.080
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发表时间：
2015-11-01
影响因子：
15.3
通讯作者：
Crook, Martin A.
中科院分区：
文献类型：
--
作者：
Charlesworth, Annika;Steger, Adrian;Crook, Martin A.
目的：继发于高脂血症（HTG）的急性胰腺炎（AP）是一种罕见的相关性，在文献中知之甚少。本研究调查患者的特点和结果（复发率和死亡率）在那些提出与AP继发于HTG在一个最大的报告British coholts.Methods：回顾性观察病例说明审查所有患者在我们的机构治疗2004年和2012年之间。如果是参数数据，则表示为平均值和标准差，如果是非参数数据，则表示为中位数和范围。完整的空腹血脂谱和患者的人口统计学资料被记录，以进一步阐明严重的高血脂症（> 10 mmol/L空腹）的原因。18例患者（2.3%）存在APHTG。血清甘油三酯峰值浓度为43.9 mmol/L，SD为18.9 mmol/L。在约10%的急性胰腺炎和高脂血症患者中，血清淀粉酶活性“假性”低（尿淀粉酶升高）。67%的患者患有2型糖尿病或糖耐量受损，28%患有脂肪肝，50%显示酒精过量，所有这些情况都与HTG相关。在就诊和最后一次随访之间，血清甘油三酯降低了94.5%。也没有死亡或AP的复发发作在研究期间。结论：APHTG是目前在2.3%的患者与AP。该队列的复发率和死亡率均为零。这可能部分是由于多学科团队积极降低血清甘油三酯。早期临床识别对于提供靶向治疗和尝试减少AP的进一步发作至关重要。(C)2015年出版集团有限公司。由爱思唯尔有限公司出版。保留所有权利。
Aim: Acute Pancreatitis (AP) secondary to hypertriglyceridaemia (HTG) is a rare association of which little is known in the literature. This study investigates patient characteristics and outcomes (reoccurrence and mortality) in those presenting with AP secondary to HTG in one of the largest reported British cohorts.Methods: A retrospective observational case note review of all patients treated at our institution between 2004 and 2012. Data are expressed as mean and standard deviation if parametric and as median and range if non-parametric. Full fasting lipid profiles and patient demographics were recorded to elucidate further the cause of the severe hypertriglyceridaemia (> 10 mmol/L fasting).Results: There were 784 patients admitted with AP admitted to our institution within the study period. APHTG was present in 18 patients (2.3%). Peak serum triglyceride concentration was 43.9 mmol/L, SD 18.9 mmol/L. Serum amylase activity was ` falsely' low (with raised urine amylase) in about 10% of the patients with acute pancreatitis and hypertriglyceridaemia. 67% of our patients had type 2 diabetes mellitus or impaired glucose tolerance, 28% had a fatty liver and 50% displayed alcohol excess all these conditions are known to be associated with HTG There was a 94.5% reduction in serum triglyceride between presentation and last follow-up visit. There were also no deaths or recurrent episodes of AP during the study period.Conclusions: APHTG was present in 2.3% of patients presenting with AP. The reoccurrence and mortality rates were zero in this cohort. This may in part be due to aggressive serum triglyceride lowering by a multi-disciplinary team. Early clinical recognition is vital to provide targeted treatment and to try and reduce further episodes of AP. (C) 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.