高脂血症性急性胰腺炎合并动脉粥样硬化严重程度的相关分析

Correlation Analysis of Hyperlipidemic Acute Pancreatitis with Atherosclerosis Severity

摘要: 目的：探讨高脂血症急性胰腺炎(HLAP)伴动脉粥样硬化(AS)的相关性分析。方法：回顾性分析2019年1月至2021年1月青岛大学附属医院全院急诊收治符合HLAP诊断标准的患者432例，并且其中伴AS患者120例，进行回顾性分析。按照既往是否诊断AS，将HLAP分为AS组(120例)和非AS组(312例)。比较两组一般资料、实验室指标、急性生理学和慢性健康状况评价II (acute physiology and chronic health evaluation II, APACHE II)、Balthazar CT评分。采用独立样本t检验、两样本秩和检验、卡方检验进行统计学比较，Kaplan-Meier生存曲线及Cox比例风险模型进行生存分析。结果：AS组与非AS组年龄、住院天数、复发次数、住院费用均有统计学意义(P均<0.05)，而性别构成(X² = 1.459，P值 > 0.05)差异无统计学意义。实验室检查指标中，AS组中与非AS组比较，低密度脂蛋白胆固醇(LDL-C)，高密度脂蛋白胆固醇(HDL-C)，总胆固醇(TC)，甘油三酯(TG)，游离脂肪酸(FFA)，脂蛋白a (LPa)，总胆汁酸(TBA)，总胆红素(TBIL)，直接胆红素(DBIL)，总钙(Ca)，肌酸激酶同工酶，胱抑素(Cys-C)，BMI (P均<0.05)两者差异存在统计学意义。而对比前白蛋白(PA)，白蛋白(ALB)，肌酐(Crea)，肌酸激酶(CK) (P > 0.05)差异无统计学意义。评分系统中AS组的Balthazar评分及APACHE II评分较非AS组升高(P < 0.05)，差异具有统计学意义。入院后基本生命体征中，呼吸频率与体温两者比较存在差异，其余差异无统计学意义。Kaplan-Meier生存曲线，AS组较非AS组住院时间明显延长，AS组平均值为29.50，非AS组的平均值为12.57，X² = 111.26，P < 0.001，95%置信区间(11.353, 13.786)。Cox比例风险模型，X² = 103.274，P < 0.001。结论：AS是HLAP发生的危险因素，伴有AS的HLAP患者再发率明显升高，预后明显较差。

Abstract: Objective: To investigate the correlation between hyperlipidemic acute pancreatitis (HLAP) and atherosclerosis (AS). Methods: A total of 432 patients who met the diagnostic criteria of HLAP admitted to the Affiliated Hospital of Qingdao University from January 2019 to January 2021, including 120 patients with AS, were retrospectively analyzed. According to the previous diagnosis of AS, HLAP was divided into AS group (120 cases) and non-AS group (312 cases). General data, laboratory indicators, acute physiology and chronic health evaluation II (Apache Arch) and Balthazar CT scores were compared between the two groups. The independent sample t test, the rank sum test of the two samples and the chi-square test were used for statistical comparison. The Kaplan-Meier survival curve and Cox proportional risk model were used for survival analysis. Results: There were statistically significant differences in age, length of stay, frequency of recurrence and hospitalization cost between AS group and non-AS group (P < 0.05), while there was no statistically significant difference in gender composition (P value > 0.05). In the laboratory tests, compared with the non-AS group, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), Total cholesterol (TC), triglyceride (TG), free fatty acid (FFA), Lipoprotein A (LPA), total bile acid (TBA), total bilirubin (TBIL), Direct bilirubin (DBIL), Total calcium (Ca), creatine kinase isoenzyme, Cystatin (Cys-C), BMI, (P < 0.05). There was no significant difference in prealbumin (PA), albumin (ALB), creatinine (CREA) and creatine kinase (CK) (P > 0.05). In the scoring system, Balthazar score and Apache II score in AS group were higher than those in non-AS group (P < 0.05), and the differences were statistically significant. In the basic vital signs after admission, there were differences between respiratory rate and body temperature, while the other differences were not statistically significant. Kaplan-Meier survival curve showed that the hospital stay in the AS group was significantly longer than that in the non-AS group, the mean value of the AS group was 29.50, and the mean value of the non-AS group was 12.57, X² = 111.26, P < 0.001, 95% confidence interval (11.353, 13.786). Cox proportional risk model, X² = 103.274, P < 0.001. Conclusion: AS is a risk factor for the occurrence of HLAP, and the recurrence rate of HLAP patients with AS is significantly increased and the prognosis is significantly poor.