高甘油三酯血症性胰腺炎合并糖尿病酮症酸中毒的临床特征分析

余姗姗; 金魁; 付阳阳; 徐军; 于学忠

doi:10.13201/j.issn.1009-5918.2019.07.002

高甘油三酯血症性胰腺炎合并糖尿病酮症酸中毒的临床特征分析

- 中国医学科学院北京协和医学院北京协和医院急诊科(北京, 100730)
基金项目:
中国医学科学院医学与健康科技创新工程项目(No:2016-I2M-1-003)

详细信息

通讯作者: 于学忠,E-mail:yxzpumch@126.com

中图分类号: R576

收稿日期: 2019-03-18

Analysis of clinical characteristics of hypertriglyceridemic pancreatitis complicated with diabetic ketoacidosis

- Department of Emergency, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, 100730, China

More Information

Corresponding author: YU Xuezhong, E-mail: yxzpumch@126.com

Received Date: 18 March 2019

摘要

摘要: 目的: 回顾性分析高甘油三酯血症性胰腺炎(HTGP)合并和不合并糖尿病酮症酸中毒(DKA)的临床特征。方法: 回顾北京协和医院2013-01-01—2018-08-01期间收治的HTGP患者病历,根据是否合并DKA分为DAK组和非DKA组。通过病案管理系统采集人口学和临床资料,进行比较分析。结果: ①共159例患者纳入研究,其中DKA组48例(30.19%),非DKA组111例(69.81%);两组患者性别、年龄比较差异无统计学意义(P>0.05);在HTGP的继发因素中体质指数(BMI≥24)、HTG史比较,差异有统计学意义(P<0.05);②DKA组血清甘油三酯(TG)、葡萄糖(GLU)均明显高于非DKA组,差异有统计学意义(P<0.05);③两组患者中重度急性胰腺炎(MSAP)发生率、血管活性药物使用率、持续肾脏替代治疗(CRRT)率上差异有统计学意义(P<0.05);④DKA组入院后24h、48h、72h累计补液量均高于非DKA组,差异有统计学意义(P<0.05)。结论: HTGP患者合并DKA时其病情严重程度并没有相应的增加,但合并DKA的患者早期循环容量不足的情况更加突出,并伴随短暂的器官功能障碍。
- 高甘油三酯血症性胰腺炎 /
- 糖尿病酮症酸中毒 /
- 急性胰腺炎
Abstract: Objective: To evaluate clinical features of hypertriglyceridemic pancreatitis(HTGP)with and without diabetic ketoacidosis(DKA).Method: HTGP patients of PUMCH were enrolled from January 1,2013 to August 1,2018 by retrospective study,and all cases were divided into two groups with and without DKA.Demographics and clinical characteristics of the groups were collected and compared using the electronic system of PUMCH.Result: A total of 159 cases of HTGP patients were enrolled in this study,48(30.19%)patients in DAK group and 111(69.81%)patients in the non-DKA group.There was no significant difference of gender and age between the two groups(P>0.05),whereas body mass index(BMI≥24),rate of HTG medical history(P<0.05).The levels of serum triglyceride(TG),and glucose(GLU)were significantly higher in the DKA group than those in the non-DKA group(P<0.05).oreover,the incidence of moderately severe acute pancreatitis(MSAP),use of vasoactive drugs and continuous renal replacement therapy(CRRT)was more common in the DKA group than the non-DKA group(P<0.05).However,the volume of fluid administration in 24 hours,48 hours,and 72 hours in the DKA group was significantly higher than that in the non-DKA group(P<0.05).Conclusion: The HTGP patients with the DKA didn't increase the severity of the pancreatitis.However,early volume insufficiency in patients with DKA is more prominent,accompanied by short-term organ dysfunction.
- hypertriglyceridemic pancreatitis /
- diabetic ketoacidosis /
- acute pancreatitis

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