血清甘油三酯水平与急性胰腺炎病情严重程度及预后相关性分析

邓盛瑜; 常杏; 杨歆; 杨仕明; 凌贤龙

doi:10.16016/j.1000-5404.201611254

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血清甘油三酯水平与急性胰腺炎病情严重程度及预后相关性分析

临床医学 | 更新时间：2026-02-09

- 血清甘油三酯水平与急性胰腺炎病情严重程度及预后相关性分析
- Serum triglyceride levels are associated with the severity and prognosis of acute pancreatitis
- 第三军医大学学报 2017年39卷第10期页码：1031-1035
- 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：
  
  [凌贤龙, E-mail:lingxianlong@yeah.netLing Xianlong, E-mail:lingxianlong@yeah.net
- 基金信息：
- DOI：10.16016/j.1000-5404.201611254
  中图分类号： R181.32;R446.11;R576
- 收稿：2016-11-30，
  
  修回：2016-12-28，
  
  纸质出版：2017-05-30
- 稿件说明：
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邓盛瑜, 常杏, 杨歆, 等. 血清甘油三酯水平与急性胰腺炎病情严重程度及预后相关性分析[J]. 第三军医大学学报, 2017,39(10):1031-1035.

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.
邓盛瑜, 常杏, 杨歆, 等. 血清甘油三酯水平与急性胰腺炎病情严重程度及预后相关性分析[J]. 第三军医大学学报, 2017,39(10):1031-1035. DOI： 10.16016/j.1000-5404.201611254.

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

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