高脂血症性急性胰腺炎临床特点分析

Clinical Characteristics of Hyperlipidemic Acute Pancreatitis

摘要: 目的：探讨高脂血症性急性胰腺炎的临床特点，以期为其临床防治提供帮助。方法：采用回顾性研究方法收集肝胆外科2021年1月至2022年12月收治的高脂血症急性胰腺炎及胆源性急性胰腺炎患者的临床资料。结果：112例急性胰腺炎患者中，高脂血症胰腺炎(HLAP)组42例，胆源性胰腺炎(BAP)组70例。1) 高脂血症性胰腺炎患者更年轻，BMI指数更高，且其中78.6%合并糖尿病，37.8%合并脂肪肝，37.5%合并高尿酸血症，明显高于胆源性胰腺炎患者(p < 0.05)。2) 高脂血症胰腺炎患者淀粉酶、脂肪酶水平显著低于胆源性胰腺炎者，且满足诊断标准的比例仅为28.2%、64.9% (p < 0.05)；高脂血症胰腺炎患者各项肝功指标，如总胆红素、碱性磷酸酶、γ谷氨酰基转移酶、谷丙转氨酶、谷草转氨酶均明显低于胆源性胰腺炎者(p < 0.05)；高脂血症胰腺炎患者的总胆固醇、甘油三酯水平明显著高于胆源性胰腺炎者(p < 0.05)。3) 易复发、易重症也是高脂血症胰腺炎的重要特点(p < 0.05)。结论：高脂血症胰腺炎在发病情况、检验结果、并发症及复发情况等方面具有自身特点，充分认识这些特点，有助于提升高脂血症胰腺炎的治疗水平。

Abstract: Objective: To investigate the clinical characteristics of hyperlipidemic acute pancreatitis (HLAP) in order to provide clinical guidance for its prevention and treatment. Methods: Retrospective study was conducted to collect clinical data of patients with HLAP and biliary acute pancreatitis (BAP) admitted to the Department of Hepatobiliary Surgery from January 2021 to December 2022. Re-sults: Among the 112 cases of acute pancreatitis, 42 cases were classified as HLAP and 70 cases as BAP. 1) Patients with HLAP were younger and had a higher BMI, with 78.6% of them also having diabetes, 37.8% having fatty liver, and 37.5% having hyperuricemia, which were significantly higher than those in the BAP group (p < 0.05). 2) The levels of amylase and lipase in HLAP patients were significantly lower compared to those in BAP patients, with only 28.2% and 64.9% of HLAP patients meeting the diagnostic criteria (p < 0.05). Liver function indicators such as total bilirubin, alkaline phosphatase, γ-glutamyl transferase, alanine aminotransferase, and aspartate ami-notransferase were significantly lower in HLAP patients compared to BAP patients (p < 0.05). 3) The levels of total cholesterol and triglycerides in HLAP patients were significantly higher than those in BAP patients (p < 0.05). The propensity for relapses and severe cases was also a notable feature of HLAP (p < 0.05). Conclusion: HLAP has distinct characteristics in terms of its onset, diagnostic re-sults, complications, and relapse propensity. Understanding these characteristics will help improve the treatment of HLAP.