高甘油三酯血症性急性胰腺炎的治疗研究进展

Research Progress on the Treatment of Hypertriglyceridemic Acute Pancreatitis

摘要: 急性胰腺炎是各种因素导致胰酶在胰腺内被激活使胰腺组织自身消化，出现局部炎症、水肿、坏死的临床常见疾病。高甘油三酯血症性急性胰腺炎(Hypertriglyceridemic Acute Pancreatitis, HTG-AP)的临床表现与其他病因引起的胰腺炎相似，但病情凶险，进展迅速，并发症较多且发病率呈逐年上升趋势，其发病机制与治疗策略仍存诸多不明。本文系统综述HTG-AP的发病机制、临床特征及治疗进展，涵盖传统支持治疗、血脂调控、胰岛素治疗、肝素治疗、血浆置换、中药治疗及基因治疗等手段并重点分析其适应症、疗效与安全性。通过梳理文献与病例，总结治疗优劣并展望研究方向，为临床提供循证参考，助力诊治规范化与预后改善。

Abstract: Acute pancreatitis (AP) is a common clinical disease: intra-pancreatic enzyme activation causes pancreatic self-digestion, inflammation, edema and necrosis. Hypertriglyceridemic Acute Pancreatitis (HTG-AP) has similar clinical manifestations to AP of other etiologies but features severe condition, rapid progression, high complication rate and rising annual incidence, with its pathogenesis and therapeutic strategies remaining unclear. This article reviews HTG-AP’s pathogenesis, clinical features and therapeutic advances (traditional supportive therapy, lipid regulation, insulin therapy, heparin therapy, plasmapheresis, traditional Chinese medicine therapy, gene therapy), focusing on their indications, efficacy and safety. By synthesizing literature and cases, it summarizes treatment pros and cons, prospects research directions, offers clinical evidence-based references, and promotes diagnosis and treatment standardization and prognosis improvement.