摘要
目的探讨老年急性胰腺炎(acute pancreatitis,AP)患者的临床特征以及年龄是否与AP的严重程度及预后相关。方法回顾性分析2013年1月至2019年12月西南医科大学附属医院消化内科收治的3642例AP患者,分为非老年组(<65岁,2955例)和老年组(≥65岁,687例)。收集两组患者的临床资料,采用统计学方法进行分析。结果(1)老年组年龄(73.5±6.3)岁,非老年组年龄(45.1±10.5)岁,老年组以女性为主且比例高于非老年组(61.9%vs 41.8%,P<0.05);在既往病史方面,老年组合并胆道疾病、糖尿病、高血压等疾病比例高于非老年组(15.4%vs 8.8%,12.5%vs 5.6%,30.0%vs 8.1%,P<0.05)。(2)老年组因高脂饮食、饮酒、高脂饮食+饮酒诱发AP比例低于非老年组(P<0.05);老年组以胆道疾病为病因的比例高于非老年组,而高脂血症、饮酒、胆道疾病+高脂血症比例低于非老年组(P<0.05)。(3)老年组重症急性胰腺炎(severe acute pancreatitis,SAP)比例高于非老年组(19.5%vs 17.3%),老年组复发AP比例低于非老年组(13.1%vs 25.0%)(P均<0.05)。(4)局部并发症方面,两组比较,差异均无统计学意义(P>0.05);在全身并发症方面,老年组发生肺炎、多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)比例高于非老年组(2.5%vs 0.9%、6.7%vs 4.0%,P<0.05)。(5)老年组死亡比例、住院天数及住院费用均高于非老年组(P均>0.05)。(6)复发是SAP发生的独立危险因素,而年龄、病因为高脂血症是死亡的独立危险因素。结论老年AP患者以女性为主,病因多为胆源性因素,易并发肺炎及MODS,年龄是死亡的独立危险因素但不是SAP的独立影响因素。随着我国人口的逐渐老龄化,明确老年AP患者的临床特点对于制订治疗策略和优化治疗方案具有重要意义。
Objective To investigate the clinical features and whether age of elderly patients with acute pancreatitis(AP)are related to the severity and prognosis of AP.Methods According to the inclusion and exclusion criteria,3642 patients with AP in the Department of Gastroenterology,the Affiliated Hospital of Southwest Medical University from Jan.2013 to Dec.2019 were retrospectively divided into non-elderly group(<65 years old,2955 cases)and elderly group(≥65 years old,687 cases).The clinical data of the patients was collected,and was analyzed through statistical methods.Results(1)The age of the elderly group was(73.5±6.3)years old,and the age of the non-elderly group was(45.1±10.5)years old.The elderly group was dominated by female and the proportion was higher than that of the non-elderly group(61.9%vs 41.8%,P<0.05).In the past medical history,the proportion of elderly patients with biliary diseases,diabetes,hypertension was higher than that of non-elderly groups(15.4%vs 8.8%,12.5%vs 5.6%,30.0%vs 8.1%,P<0.05).(2)The proportion of AP induced by high-fat diet,dringing,high-fat diet+drinking in the elderly group was lower than that in the non-elderly group(P<0.05).The proportion of the elderly group with biliary tract disease as the etiology was higher than that of the non-elderly group,but the proportion of hyperlipidemia,drinking,biliary diseases+hyperlipidemia was lower than that of the non-elderly group(P<0.05).(3)The proportion of severe acute pancreatitis(SAP)in the elderly group was higher than that in the non-elderly group(19.5%vs 17.3%),the proportion of recurrent AP in the elderly group was lower than that in the non-elderly group(13.1%vs 25.0%)(all P<0.05).(4)In terms of local complications,the difference between the two groups was not statistically significant(P>0.05).In terms of systemic complications,the proportion of pneumonia and multiple organ dysfunction syndrome(MODS)in the elderly group was higher than that in the non-elderly group(2.5%vs 0.9%,6.7%vs 4.0%,P<0.05).(5)The death rate,hospitalization
作者
罗旭娟
彭燕
陈霞
LUO Xujuan;PENG Yan;CHEN Xia(Department of Gastroenterology,the Affiliated Hospital of North Sichuan Medical College,Nanchong 637099;Department of Gastroenterology,the Affiliated Hospital of Southwest Medical University,China)
出处
《胃肠病学和肝病学杂志》
CAS
2022年第4期438-443,共6页
Chinese Journal of Gastroenterology and Hepatology
基金
四川省中医药管理局(2020JC0056)。
关键词
急性胰腺炎
老年人
胆道疾病
Acute pancreatitis
Elderly
Biliary disease
