Serum triglyceride levels are associated with the severity and prognosis of acute pancreatitis

Shengyu Deng; Xing Chang; Xin Yang; Shiming Yang; Xianlong Ling

doi:10.16016/j.1000-5404.201611254

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Serum triglyceride levels are associated with the severity and prognosis of acute pancreatitis

Clinical Medicine | 更新时间：2026-02-09

- Serum triglyceride levels are associated with the severity and prognosis of acute pancreatitis
- Journal of Third Military Medical University Vol. 39, Issue 10, Pages: 1031-1035(2017)
- 作者机构：
  
  400037 重庆，第三军医大学新桥医院消化内科
- 作者简介：
- 基金信息：
- DOI：10.16016/j.1000-5404.201611254
  CLC： R181.32;R446.11;R576
- Received：30 November 2016，
  
  Revised：2016-12-28，
  
  Published：30 May 2017
- 稿件说明：
移动端阅览
Shengyu Deng, Xing Chang, Xin Yang, et al. Serum triglyceride levels are associated with the severity and prognosis of acute pancreatitis[J]. Journal of Third Military Medical University, 2017, 39(10): 1031-1035.
DOI：

Shengyu Deng, Xing Chang, Xin Yang, et al. Serum triglyceride levels are associated with the severity and prognosis of acute pancreatitis[J]. Journal of Third Military Medical University, 2017, 39(10): 1031-1035. DOI： 10.16016/j.1000-5404.201611254.

摘要

目的

探讨血清甘油三酯(triglyceride，TG)水平与急性胰腺炎(acute pancreatitis，AP)患者病情严重程度及预后的相关性。

方法

收集2012年1月至2015年9月期间本科466例AP患者资料

按血清TG值是否高于1.70 mmol/L分为正常组与升高组，升高组再分为轻、中、重组，比较病情严重程度及预后有无差异，以是否合并全身炎症反应综合征(systemic inflammatory response syndrome，SIRS)为因变量，进行Logistic回归分析。比较重度血脂升高组血液净化治疗前后指标。

结果

466例AP患者中血脂升高组271例(58.2%)，血脂正常组195例(41.8%)，血脂升高组SIRS(42.8%

23.6%，

0.01)、胸腔积液(55.0%

43.1%，

0.05)、病情程度(30.6%

19.5%，

0.01) 明显高于正常组；组间器官功能障碍(13.7%

13.8%)差异无统计学意义(

0.05)；随着TG升高，各组并发SIRS风险越高(

0.01)。Logistic回归分析TG与SIRS独立相关(

=1.157，95%

：1.102~1.215，

0.01)。重度血脂升高组中使用血液净化(29例)治疗后，TG水平、白细胞计数、APACHEⅡ评分与治疗前比较明显降低(

0.01)。

结论

TG升高的AP患者预后更差，血清TG水平越高，SIRS发生率越高，但合并器官功能障碍无差异。血液净化能有效缓解血脂重度升高患者的病情。

Abstract

Objective

To investigate the association between serum triglyceride (TG) levels and the severity and clinical outcomes of acute pancreatitis (AP).

Methods

Patients with AP admitted consecutively in our department from January 2012 to September 2015 were analyzed. According to serum TG levels

the patients were divided into normal TG group and elevated TG (>1.70 mmol/L) group

and the latter was further divided into mild

moderate

and severe groups. The disease severity and clinical outcomes were compared among patients with different TG levels

and logistic regression analysis was used for analyzing systemic inflammatory response syndrome (SIRS). The changes were analyzed in serum TG levels

white blood cell counts and APACHE Ⅱ scores after treatment.

Results

A total of 466 AP patients were enrolled

including 195 with normal TG levels and 271 with elevated TG levels (176 mild

54 moderate and 41 severe cases). Compared with those with normal serum TG levels

the patients with elevated TG levels were more likely to have SIRS (42.8%

23.6%

0.001)

pleural effusion (55.0%

43.1%

=0.011)

and severe conditions (30.6%

19.5%

0.007)

but the incidence of organ dysfunction was comparable between the 2 groups (13.7%

13.8%). Elevated serum TG levels was correlated with an increased risk of SIRS (

0.001)

and logistic regression analysis showed that TG was independently related to SIRS (

=1.157

95%

: 1.102~1.215;

0.001). TG levels

white blood cell counts and APACHE Ⅱ scores were significantly decreased (

0.001) after blood purification in 29 patients with severely elevated TG levels.

Conclusion

In AP patients

an elevated TG level is associated with a poorer outcome and an increased risk of SIRS but does not affect the risk of organ dysfunction. Blood purification can effectively alleviate the condition of patients with severely elevated TG levels.

关键词

Keywords

references

张娜, 张海燕, 郭晓红, 等.中国近十年急性胰腺炎病因变化特点的Meta分析[J].中华消化病与影像杂志:电子版, 2016, 6(2): 71-75. DOI: 10.3877/cma.j.issn.2095-2015.2016.02.006.

Zhang N, Zhang H Y, Guo X H, et al. Changes of etiology in acute pancreatitis in recent 10 years in China: Meta-analysis[J]. Chin J Digest Med Imageol (Electronic Edition), 2016, 6(2): 71-75. DOI: 10.3877/cma.j.issn.2095-2015.2016.02.006.

何文华, 祝荫, 朱勇, 等.高甘油三酯血症与其他病因所致急性胰腺炎的病情严重程度及预后比较[J].中华医学杂志, 2016, 96(32): 2569-2572. DOI: 10.3760/cma.j.issn.0376-2491.2016.32.011.

He W H, Zhu M, Zhu Y, et al.Comparison of severity and clinical outcomes between hypertriglyceridemic pancreatitis and acute pancreatitis due to other causes[J]. Natl Med J China, 2016, 96(32): 2569-2572. DOI: 10.3760/cma.j.issn.0376-2491.2016.32.011.

Nawaz H, Koutroumpakis E, Easler J, et al. Elevated serum triglycerides are independently associated with persistent organ failure in acute pancreatitis[J]. Am J Gastroenterol, 2015, 110(10): 639-654. DOI: 10.1038/ ajg.2015.261.

Tenner S, Baillie J, DeWitt J, et al. American College of Gastroenterology guideline: management of acute pancreatitis[J]. Am J Gastroenterol, 2013, 108(9): 1400-1415;1416. DOI: 10.1038/ajg.2013.218.

中华医学会消化病学分会胰腺疾病学组.中国急性胰腺炎诊治指南(2013年, 上海)[J].中华消化杂志, 2013, 33(4): 530-535. DOI: 10.3760/cma.j.issn.0254-1432.2013.04.001.

Pancreas Study Group, Chinese Society of Gastroenterology, Chinese Medical Association. Chinese guidelines for the management of acute pancreatitis (Shanghai, 2013)[J]. Chin J Dig, 2013, 33(4): 530-535. DOI: 10.3760/cma.j.issn.0254-1432.2013.04.001.

叶欣, 赵洪川.急性胰腺炎合并全身炎症反应综合征的危险因素分析[J].医学研究生学报, 2012, 25(3): 274-278. DOI: 10.3969/j.issn.1008-8199.2012.03.013.

Ye X, Zhao H C.Risk factors of acute pancreatitis complicated with systemic inflammatory response syndrome[J]. J Med Postgra, 2012, 25(3): 274-278. DOI: 10.3969/j.issn.1008-8199.2012.03.013.

王甘露, 侍立志, 林建山, 等.高脂血症性急性胰腺炎的临床研究[J].实用医学杂志, 2011, 27(15): 2757-2760. DOI: 10.3969/j.issn.1006-5725.2011.15.026.

Wang G L, Shi L Z, Lin J S, et al.Clinical study of hyperinficemic acute pancreatitis[J]. The J Pract Med, 2011, 27(15): 2757-2760. DOI: 10.3969/j.issn.1006-5725.2011.15.026.

李邦一, 张玫, 和芳, 等.新分级标准下血脂与急性胰腺炎病情严重程度的相关性[J].实用医学杂志, 2015, 31(16): 2704-2706. DOI: 10.3969/j.issn.1006-5725.2015.16.039.

Li B Y, Zhang W, He F, et al. Correlation between Blood Lipid and Severity of Acute Pancreatitis in New Classification Criteria[J]. The J Pract Med, 2015, 31(16): 2704-2706. DOI: 10.3969/j.issn.1006-5725.2015.16.039.

邵伟, 赵二鹏, 傅强, 等.血液净化对重症急性胰腺炎伴重度高脂血症的作用[J].中国中西医结合外科杂志, 2009, 15(5): 509-511. DOI: 10.3969/j.issn.1007-6948.2009.05.015.

Shao W, Zhao E P, Fu Q, et al.Blood purification for severe acute pancreatitis with severe hyperlipidemia[J]. Chin J Surg Integr Tradit West Med, 2009, 15(5): 509-511. DOI: 10.3969/j.issn.1007-6948.2009.05.015.

Wang S, Chou Y, Shangkuan W, et al. Relationship between plasma triglyceride level and severity of hypertriglyceridemic pancreatitis.[J]. PLoS One, 2016, 11(10): e163984. DOI: 10.1371/journal.pone.0163984.

Gonz lezmoreno E I, Garzagonz lez E, Bosquespadilla F J, et al. Elevated serum triglycerides associated with systemic inflammatory response syndrome and persistent organ failure in acute pancreatitis[J]. Am J Gastroenterol, 2016, 111(1): 149.DOI: 10.1038/ajg.2015.388.

Bosques-Padilla F J, V zquez-Elizondo G, Gonz lez-Santiago O, et al. Hypertriglyceridemia-induced pancreatitis and risk of persistent systemic inflammatory response syndrome[J]. Am J Med Sci, 2015, 349(3): 206-211. DOI: 10.1097/MAJ.0000000000000392.

虞文魁, 石佳靓.重症急性胰腺炎血液净化治疗[J].中国实用内科杂志, 2016(5): 365-367. DOI: 10.7504/nk2016040107.

Yu W K, Shi J L.Bloodpurification treatment in severe acute pancreatitis[J]. Chin J Prac Intern Med, 2016(5): 365-367.DOI:10.7504/nk2016040107.

Noel P, Patel K, Durgampudi C, et al. Peripancreatic fat necrosis worsens acute pancreatitis independent of pancreatic necrosis via unsaturated fatty acids increased in human pancreatic necrosis collections[J]. Gut, 2016, 65(1): 100-111.DOI: 10.1136/gutjnl-2014-308043.

Hamada S, Masamune A, Kikuta K, et al. Clinical impact of elevated serum triglycerides in acute pancreatitis: validation from the nationwide epidemiological survey in Japan[J]. Am J Gastroenterol, 2016, 111(4): 575-576. DOI: 10.1038/ajg.2015.421.

黄惠斌, 郑文贺, 李莹, 等.持续静脉-静脉血液滤过治疗高脂血症性胰腺炎的系统评价[J].中国循证医学杂志, 2014(05): 611-617. DOI:10.7507/1672-2531.20140101.

Huang H B, Zheng W H, Li Y, et al. Continuous Veno-venous Hemofi ltration for Patients with Hyperlipidemic Pancreatitis:A Systematic Review[J]. Chin J Evid-based Med, 2014(05): 611-617. DOI: 10.7507/1672-2531.20140101.

武世文, 刘勇坚, 周洁, 等.血浆置换治疗高脂血症胰腺炎临床效果的Meta分析[J].第三军医大学学报, 2013, 35(6): 527-531. DOI: 10.16016/j.1000-5404.2013.06.019.

Wu S W, Liu Y J, Zhou J, et al. Effect of plasma exchange on patients with hyperlipidemic pancreatitis:a meta analysis[J]. J Third Mil Med Univ, 2013, 35(6): 527-531. DOI: 10.16016/j.1000-5404.2013.06.019.

Gavva C, Sarode R, Agrawal D, et al. Therapeutic plasma exchange for hypertriglyceridemia induced pancreatitis: A rapid and practical approach[J]. Transfus Apher Sci, 2016, 54(1): 99-102. DOI: 10.1016/j.transci.2016. 02.001.

Valdivielso P, Ram rez-Bueno A, Ewald N. Current knowledge of hypertriglyceridemic pancreatitis.[J]. Eur J Intern Med, 2014, 25(8): 689-694. DOI: 10.1016/j.ejim. 2014.08.008.

Click B, Ketchum A M, Turner R, et al. The role of apheresis in hypertriglyceridemia-induced acute pancreatitis: A systematic review[J]. Pancreatology, 2015, 15(4): 313-320. DOI: 10.1016/j.pan.2015.02.010.

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