Comparison of clinical features between hypertriglyceridemia-induced acute pancreatitis and biliary acute pancreatitis

doi:10.3877/cma.j.issn.2095-3232.2020.05.011

Abstract

Abstract:

Objective

To compare the clinical features between hypertriglyceridemia-induced acute pancreatitis (HTG-AP) and biliary acute pancreatitis (BAP).

Methods

Clinical data of 465 patients with acute pancreatitis admitted to Affiliated Hospital of North Sichuan Medical College from July 2008 to October 2016 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 343 patients were male and 122 female, aged 38-54 years with a median age of 51 years. 51 patients were assigned into the HTG-AP group and 414 cases in the BAP group. Clinical features, such as baseline data and postoperative complications, were observed between two groups. The amylase and lipase levels between two groups were statistically compared by t test. The rate comparison was conducted by Chi-square test or Fisher's exact test.

Results

The average age of patients in the HTG-AP group was (40±2) years, significantly younger than (52±2) years in the BAP group (t=-38.52, P<0.05). In the HTG-AP group, the proportion of male, diabetes mellitus patients were 90%(46/51) and 31%(16/51) respectively, significantly higher than 72%(297/414) and 12%(48/414) in the BAP group (χ2=7.93, 14.97; P<0.05). Body mass index (BMI) and C-reactive protein (CRP) in the HTG-AP group were (30.6±2.2) kg/m² and (129±8) mg/L, significantly higher than (26.0±1.5) kg/m² and (58±4) mg/L in the BAP group (t=19.49, 103.90; P<0.05). The incidence of acute respiratory distress syndrome (ARDS), acute kidney injury (AKI) and multiple organ dysfunction syndrome (MODS) in the HTG-AP group was 16%(8/51), 22%(11/51) and 16%(8/51), significantly higher than 3%(12/414), 1%(5/414) and 2%(10/414) in the BAP group (χ2=18.04, 56.66, 21.49; P<0.05).

Conclusions

Compared with BAP, HTG-AP is more common in young and obese men with a higher incidence of diabetes mellitus and severe complications, such as organ failure.

Key words: Pancreatitis, Hypertriglyceridemia, Complications

Shu Yan, Yong Li, Jingyan Fan, Nisha Wu, Guojun Zhou, Jianshui Li, Zhengwei Leng. Comparison of clinical features between hypertriglyceridemia-induced acute pancreatitis and biliary acute pancreatitis[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2020, 09(05): 445-448.

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References 21

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组别	例数	年龄（岁，±s）	性别（男/女）	BMI（kg/m²，±s）	APACHE评分（±s）	高血压（例）	糖尿病（例）	MAP（例）	MSAP（例）	SAP（例）
HTG-AP组	51	40±2	46/5	30.6±2.2	26.4±2.7	11	16	32	13	6
BAP组	414	52±2	297/117	26.0±1.5	26.1±2.0	73	48	269	115	32
统计值	?	t=-38.52	χ²=7.93	t=19.49	t=0.97	χ²=0.48	χ²=14.97	χ²=0.10	χ²=0.12	χ²=0.99
P值	?	<0.001	0.005	<0.001	0.333	0.491	<0.001	0.753	0.730	0.321

组别	例数	年龄（岁，±s）	性别（男/女）	BMI（kg/m²，±s）	APACHE评分（±s）	高血压（例）	糖尿病（例）	MAP（例）	MSAP（例）	SAP（例）
HTG-AP组	51	40±2	46/5	30.6±2.2	26.4±2.7	11	16	32	13	6
BAP组	414	52±2	297/117	26.0±1.5	26.1±2.0	73	48	269	115	32
统计值	?	t=-38.52	χ²=7.93	t=19.49	t=0.97	χ²=0.48	χ²=14.97	χ²=0.10	χ²=0.12	χ²=0.99
P值	?	<0.001	0.005	<0.001	0.333	0.491	<0.001	0.753	0.730	0.321

组别	例数	淀粉酶（U/L）	脂肪酶（U/L）	WBC（个/ L）	CRP（mg/L）	PCT（μg/L）	Scr（μmol/L）	TB（μmol/L）	ALT（U/L）	AST（U/L）	Hb（g/L）	Plt（×109个/ L）	PT（s）	APTT（s）
HTG-AP组	51	653±101	951±54	15±6	129±8	1.25±0.17	76±14	48±6	86±7	104±16	148±22	246±40	13±5	35±5
BAP组	414	678±31	961±43	13±5	58±4	1.25±0.09	78±13	47±5	85±6	102±17	146±22	242±25	12±6	35±4
t值	?	-43.39	-1.52	2.63	103.90	0.00	-1.03	1.32	1.10	0.80	0.61	1.00	1.14	0.00
P值	?	<0.001	0.129	0.009	<0.001	0.999	0.305	0.189	0.271	0.426	0.541	0.319	0.254	0.999

组别	例数	淀粉酶（U/L）	脂肪酶（U/L）	WBC（个/ L）	CRP（mg/L）	PCT（μg/L）	Scr（μmol/L）	TB（μmol/L）	ALT（U/L）	AST（U/L）	Hb（g/L）	Plt（×109个/ L）	PT（s）	APTT（s）
HTG-AP组	51	653±101	951±54	15±6	129±8	1.25±0.17	76±14	48±6	86±7	104±16	148±22	246±40	13±5	35±5
BAP组	414	678±31	961±43	13±5	58±4	1.25±0.09	78±13	47±5	85±6	102±17	146±22	242±25	12±6	35±4
t值	?	-43.39	-1.52	2.63	103.90	0.00	-1.03	1.32	1.10	0.80	0.61	1.00	1.14	0.00
P值	?	<0.001	0.129	0.009	<0.001	0.999	0.305	0.189	0.271	0.426	0.541	0.319	0.254	0.999

组别	例数	ARDS	AKI	腹内高压	休克	腹腔内出血	门静脉血栓	深静脉血栓	急性肝损伤	胃肠道瘘	消化道出血	肠梗阻	MODS	急性胰周积液	胰腺假性囊肿	急性坏死性积液
HTG-AP组	51	8	11	1	1	0	0	0	1	0	1	0	8	14	2	4
BAP组	414	12	5	2	15	1	1	1	8	6	2	16	10	111	9	12
χ²值	?	18.04	56.66	1.55	0.38	-	-	-	0.00	-	1.55	-	21.49	0.01	0.60	3.34
P值	?	<0.001	<0.001	0.214	0.539	0.725	0.725	0.725	0.989	0.387	0.214	0.153	<0.001	0.923	0.438	0.068

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