摘要
目的 探讨新疆维吾尔族高脂血症性重症急性胰腺炎患者的临床特点及血浆置换治疗效果.方法 回顾性收集2007年8月至2012年8月确诊为高脂血症性重症急性胰腺炎的91例患者的临床特点及治疗效果.其中开展血浆置换治疗前仅接受内科治疗的维吾尔族患者（对照组）50例,开展血浆置换后在内科治疗的基础上接受血浆置换治疗的维吾尔族患者41例（治疗组）.收集同期收治的72例汉族高脂血症性重症急性胰腺炎患者的临床资料,并与维吾尔族高脂血症性重症急性胰腺炎患者进行对比分析.分别采用t检验、x2检验、对研究数据进行统计学分析.结果 治疗组及对照组患者性别、年龄、入院时APACHEⅡ评分、体重指数及血脂水平无统计学差异.治疗组41例通过常规内科及血浆置换治疗后32例患者重症急性胰腺炎症状体征明显好转,余患者治疗无效后死亡9例;对照组50例中死亡22例,好转28例,治疗组病死率低于对照组（x2=10.824,P=0.001）.此外治疗组总住院天数为（17 ±16）d,短于对照组的（28±20）d（=2.851,P=0.005）.治疗组血浆置换前血浆甘油三酯和总胆固醇水平分别为（58±39） mmol/L及（24±8）mmol/L,治疗结束后分别降至（10±10）mmol/L及（6±5）mmol/L.血浆置换后患者血浆甘油三酯及总胆固醇水平下降（=8.300,P=0.000;t=13.237,P=0.000）.死亡病例APACHEⅡ评分为18±2,高于未死亡病例的11 ±3（t =0.570,P=0.000）;死亡患者入院至血浆置换的间隔时间为（49±9）h,明显长于未死亡患者[（38 ±8）h,t=3.549,p=0.040];治疗组死亡病例血浆置换前甘油三酯水平为（37±15） mmol/L,低于生存患者[（46±16）mmol/L,t=2.386,P =0.010].对照组血浆甘油三酯及总胆固醇水平亦下降（t=3.484,P=0.001;=4.086,P=0.000）,但下降幅度小于治疗组.我们将治疗组及对照组91例维吾尔族患者与同期72例汉族患者对比,维吾尔族患者平均血浆甘油�
Objective To investigate the clinical features and plasmapheresis treatment outcome of hyperlipidemic acute pancreatitis among Uyghur population.Methods The clinical data of 41 cases （treatment group） diagnosed with acute hyperlipidemic pancreatitis and treated with plasmapheresis from August 2007 to August 2012 was studied,and treatment outcomes were statistically analyzed.Fifty patients during the same period who received medical treatment without plasmapheresis （control group）were collected,and were compared to the treatment group.Clinical data of 72 Han Chinese patients with hyperlipidemic acute pancreatitis from the same study period were compared to 91 Uyghur patients mentioned above.The data were analyzed by t-test or x2 test.Results Treatment group and control group were comparable in terms of gender,age,APACHE Ⅱ score at admission,BMI,and blood lipid levels.Thirty-two patients out of 41 in the treatment group were improved after routine medical treatmnent and plasmapheresis,but 9 died.In the control group,28 out of 50 cases were improved,22 died.The mortality of the treatment group was significantly lower than that of the control group（x2 =10.824,P =0.001）.Time of hospital stay in treatment group was （17 ± 16） days,and significantly shorter than that of control group （（28 ± 20）days） （t=2.851,P =0.005）.Before plasmapheresis in the treatment group,serum triglyceride and total cholesterol levels were （58 ± 39）mmol/L and （24 ± 8）mmol/L,after plasmapheresis,these values dropped significantly to （10 ± 10） mmol/L and （6 ± 5） mmol/L APACHE Ⅱ score of those died were 18 ± 2,and significantly higher than those who survived（11 ± 3） （t =0.570,P =0.000） ; Time from hospital admission until plasmapheresis were significantly longer in died patients （（49 ± 9）hours） than in survived patients （（38 ± 8）hours,t =3.549,P =0.040）.Furthermore,serum triglyceride levels were significantly higher in survived cases （（46 ± 16） mmol/L） than th
出处
《中华外科杂志》
CAS
CSCD
北大核心
2015年第3期185-188,共4页
Chinese Journal of Surgery
关键词
胰腺炎
急性坏死性
高脂血症
维吾尔族
血浆置换
Pancreatitis,acute necrotizing
Hyperlipidemias
Uyghur nationality
Plasmapheresis
