Outcome of low molecular weight heparin combined with continuous renal replacement therapy for severe acute pancreatitis

ZHOU Yi; CHEN Wei-zhi; QIU Lin; WANG Wei-di

doi:10.11659/jjssx.01E025061

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Outcome of low molecular weight heparin combined with continuous renal replacement therapy for severe acute pancreatitis

Clinical Research | 更新时间：2025-10-24

- Outcome of low molecular weight heparin combined with continuous renal replacement therapy for severe acute pancreatitis
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 34, Issue 10, Pages: 871-875(2025)
- 作者机构：
  
  福建医科大学附属第一医院创伤中心急诊外科，福建福州 350000
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.01E025061
  CLC： R576
- Received：10 January 2025，
  
  Published：25 October 2025
- 稿件说明：
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周沂,陈维志,邱琳等.低分子肝素联合连续性肾脏替代疗法治疗重症急性胰腺炎的疗效[J].局解手术学杂志,2025,34(10):871-875.

ZHOU Yi,CHEN Wei-zhi,QIU Lin,et al.Outcome of low molecular weight heparin combined with continuous renal replacement therapy for severe acute pancreatitis[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(10):871-875.
周沂,陈维志,邱琳等.低分子肝素联合连续性肾脏替代疗法治疗重症急性胰腺炎的疗效[J].局解手术学杂志,2025,34(10):871-875. DOI： 10.11659/jjssx.01E025061.

ZHOU Yi,CHEN Wei-zhi,QIU Lin,et al.Outcome of low molecular weight heparin combined with continuous renal replacement therapy for severe acute pancreatitis[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(10):871-875. DOI： 10.11659/jjssx.01E025061.

摘要

目的

探讨低分子肝素联合连续性肾脏替代疗法（CRRT）治疗重症急性胰腺炎的疗效。

方法

收集2022年6月至2023年12月本院收治的84例重症急性胰腺炎患者的临床资料，按治疗方式将患者分为CRRT组和联合组，每组42例。CRRT组患者采用CRRT治疗，联合组患者采用CRRT联合低分子肝素治疗。比较2组患者治疗前后的血清胰腺炎标志物、炎症因子、细胞间黏附分子-1（ICAM-1）及高迁移率族蛋白B1（HMGB1）水平及急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分；记录患者症状改善时间；评估患者治疗效果。

结果

与治疗前相比，治疗后2组患者血清淀粉酶（S-AMY）、胰脂肪酶（LPS）、尿淀粉酶（U-AMY）、C反应蛋白（CRP）、降钙素原（PCT）、ICAM-1、HMGB1水平及APACHEⅡ评分均显著降低（

0.05），且联合组低于CRRT组（

0.05）。治疗后，联合组患者的腹痛腹胀消失时间、肛门排便恢复时间及发热消失时间均较CRRT组显著缩短（

0.05）。联合组患者的治疗总有效率显著高于CRRT组（

0.05）。

结论

低分子肝素联合CRRT治疗重症急性胰腺炎的效果较好，能显著降低胰腺炎标志物、炎症因子、血清ICAM-1及HMGB1水平，有效改善患者临床症状，缩短症状改善时间。

Abstract

Objective

To investigate the outcome of low molecular weight heparin combined with continuous renal replacement therapy （CRRT） in the treatment of severe acute pancreatitis.

Methods

The clinical data of 84 patients with severe acute pancreatitis admitted to our hospital from June 2022 to December 2023 were collected， and the patients were divided into the CRRT group and the combination group according to their treatment methods，with 42 cases in each group. The patients in the CRRT group were treated with CRRT，while those in the combination group were treated with CRRT and low molecular weight heparin. The serum levels of pancreatitis markers，inflammatory factors，serum intercellular adhesion molecules-1 （ICAM-1） and high mobility group proteins B1 （HMGB1） and acute physiology and chronic health status evaluation Ⅱ （APACHE Ⅱ） scores were compared between the two groups， the symptom improvement time of patients were recorded，and the curative effect of patients were evaluated.

Results

The serum levels of amylase （S-AMY），pancreatic lipase （LPS），urinary amylase （U-AMY）， C-reactive protein （CRP）， ICAM-1 and HMGB1， and APACHEⅡ scores after treatment in the two groups were significantly lower than those before treatment， and the combination group was lower than the CRRT group （

0.05）. After treatment， the disappearance time of abdominal pain and abdominal bloating， the recovery time of defecation， and the disappearance time of fever in the combination group were all significantly shorter than those in the CRRT group （

0.05）. The combination group had a significantly higher overall effective rate of treatment than the CRRT group （

0.05）.

Conclusion

Low molecular weight heparin combined with CRRT is effective for on the treatment of severe acute pancreatitis， which can significantly reduce the levels of pancreatitis markers，inflammatory factors，serum ICAM-1 and HMGB1， effectively improve clinical symptoms， and shorten the time for symptom improvement.

关键词

Keywords

references

刘斐，张丽骞，高乃坤，等 . 重症急性胰腺炎继发感染性胰腺坏死APOA5基因多态性及血清LPS、sPD-L1和PCT水平［J］. 中华医院感染学杂志， 2025 ， 35 （ 5 ）： 662 - 666 . doi： 10.11816/cn.ni.2025-240734 http://dx.doi.org/10.11816/cn.ni.2025-240734 .

郭艳敏，翁瑞霞，严敏 . 重症急性胰腺炎患者连续肾脏替代疗法序贯治疗后累积液体平衡与预后的关系［J］. 中国急救医学， 2023 ， 43 （ 12 ）： 946 - 953 . doi： 10.3969/j.issn.1002-1949.2023.12.005 http://dx.doi.org/10.3969/j.issn.1002-1949.2023.12.005 .

韩雪，陈治国，郝欣 . 低分子肝素治疗重症急性胰腺炎疗效的META分析［J］. 中华医院感染学杂志， 2021 ， 31 （ 1 ）： 99 - 104 . doi： 10.11816/cn.ni.2021-201860 http://dx.doi.org/10.11816/cn.ni.2021-201860 .

李非，曹锋 . 中国急性胰腺炎诊治指南（2021）［J］. 中国实用外科杂志， 2021 ， 41 （ 7 ）： 739 - 746 . doi： 10.19538/j.cjps.issn1005-2208.2021.07.03 http://dx.doi.org/10.19538/j.cjps.issn1005-2208.2021.07.03 .

李剑锋，朱春苗，张卫芳，等 . 连续性肾脏替代疗法联合乌司他丁治疗重症急性胰腺炎患者临床效果观察［J］. 内科， 2021 ， 16 （ 3 ）： 345 - 348 . doi： 10.16121/j.cnki.cn45-1347/r.2021.03.18 http://dx.doi.org/10.16121/j.cnki.cn45-1347/r.2021.03.18 .

郑筱萸 . 中药新药临床研究指导原则：试行［M］. 中国医药科技出版社， 2002 ： 59 - 60 .

Abulimiti A ， Hssaiyin A ， Sailai Y . Evaluation of HVHF for he treatment of severe acute pancreatitis accompanying MODS ［J］. Melieine ， 2018 ， 97 （ 1 ）： 9417 - 9418 . doi： 10.1097/md.0000000000009417 http://dx.doi.org/10.1097/md.0000000000009417 .

Kjetil S ， Savio GB ， Sanjay P . Severe acute pancreatitis ［J］. Br J Surg ， 2024 ， 111 （ 8 ）： 1 - 2 . doi： 10.1093/bjs/znae170 http://dx.doi.org/10.1093/bjs/znae170 .

吴雪滢，李兰，石佳华，等 . 重症急性胰腺炎多器官功能衰竭患者早期发生毛细血管渗漏综合征的临床表征研究［J］. 四川大学学报（医学版）， 2025 ， 56 （ 1 ）： 277 - 283 . doi： 10.12182/20250160609 http://dx.doi.org/10.12182/20250160609 .

Chen ZF ， Gui CM ， Xie ZH . The effects of conimss renal replacement therapy with different anticoagulalion methods on the exprssion of cytokines in severe acute pancreatitis ［J］. Transpl Immunl ， 2022 ， 73 （ 1 ）： 101603 - 101604 . doi： 10.1016/j.trim.2022.101603 http://dx.doi.org/10.1016/j.trim.2022.101603 .

Zhang W ， Sun J ， Shen X ， et al . Percutaneous catheter drainage combined with peritoneal dialysis for treating acute severe pancreatitis：a single-center prospective study ［J］. Minerva Chir ， 2019 ， 74 （ 3 ）： 207 - 212 . doi： 10.23736/S0026-4733.18.07813-6 http://dx.doi.org/10.23736/S0026-4733.18.07813-6 .

程炯炯，李琳琳，赵浩东，等 . CRRT联合血浆置换救治高脂血症性重症急性胰腺炎患者的疗效分析［J］. 天津医药， 2023 ， 51 （ 8 ）： 855 - 859 . doi： 10.11958/20221994 http://dx.doi.org/10.11958/20221994 .

陈永康，戴晓荣，闫坤锋，等 . 重症急性胰腺炎患者连续性肾脏替代治疗后累积液体平衡与预后的关系［J］. 中国血液净化， 2024 ， 23 （ 12 ）： 910 - 914 . doi： 10.3969/j.issn.1671-4091.2024.12.006 http://dx.doi.org/10.3969/j.issn.1671-4091.2024.12.006 .

Jiang WZ ， Zhao HJ ， Chen L ， et al . Clinical evaluation of continuous renal replacement therapy combined with peritoneal lavage for severe acute pancreatitis：a retrospective cohort study ［J］. Med Sci Monit ， 2023 ， 29 ： e939314 . doi： 10.12659/MSM.939314 http://dx.doi.org/10.12659/MSM.939314 .

Ca S ， Gondesi K ， Krishna PK ， et al . Efficacy of low-molecular-weight heparin in the treatment of severe acute pancreatitis：a comparative study at a tertiary health center ［J］. Cureus ， 2024 ， 16 （ 7 ）： 65736 - 65737 . doi： 10.7759/cureus.65736 http://dx.doi.org/10.7759/cureus.65736 .

Gao N ， Yan C ， Zhang G . Changes of serum procalcitonin （PCT），C-reactive protein （CRP），interleukin-17 （IL-17），interleukin-6 （IL-6），high mobility group protein-B1 （HMGB1） and D-dimer in patients with severe acute pancreatitis treated with continuous renal replacement therapy （CRRT） and its clinical significance ［J］. Med Sci Monit ， 2018 ， 24 （ 1 ）： 5881 - 5886 . doi： 10.12659/MSM.910099 http://dx.doi.org/10.12659/MSM.910099 .

Diana I ， Adrian PS ， Marius DP ， et al . Effect of continuous renal replacement therapy on serum levels of inflammatory cytokines/interleukin-17 in severe acute pancreatitis ［J］. J Mind Med Sci ， 2024 ， 11 （ 1 ）： 78 - 83 . doi： 10.22543/2392-7674.1476 http://dx.doi.org/10.22543/2392-7674.1476 .

贺江，钱佩霞 . 连续性肾脏替代治疗对重症急性胰腺炎患者机体炎症反应的影响［J］. 现代医学与健康研究电子杂志， 2025 ， 9 （ 5 ）： 57 - 59 . doi： 10.3969/.issn.2096-3718.2025.05.019 http://dx.doi.org/10.3969/.issn.2096-3718.2025.05.019 .

Mauro P ， Valentina M ， Paola M ， et al . Effectiveness and safety of low molecular weight heparin in the management of acute pancreatitis：a systematic review and meta-analysis ［J］. World J Emerg Surg ， 2024 ， 19 （ 1 ）： 1 - 2 . doi： 10.1186/s13017-024-00558-3 http://dx.doi.org/10.1186/s13017-024-00558-3 .

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