中国全科医学 ›› 2018, Vol. 21 ›› Issue (28): 3467-3470.DOI: 10.12114/j.issn.1007-9572.2018.00.044

所属专题: 胰腺炎最新文章合集

• 专题研究 • 上一篇    下一篇

急性胰腺炎合并糖尿病的临床特点研究

王蓓蓓,廖山婴,布小玲,聂胜利,沙卫红,马娟*   

  1. 510080 广东省广州市,广东省人民医院 广东省医学科学院消化内科
    *通信作者:马娟,副主任医师,硕士生导师;E-mail:mjlqh@163.com
  • 出版日期:2018-10-05 发布日期:2018-10-05
  • 基金资助:
    基金项目:广东省自然科学基金资助项目(2016A030313765)

Clinical Characteristics of Acute Pancreatitis among Diabetic Patients

WANG Beibei,LIAO Shanying,BU Xiaoling,NIE Shengli,SHA Weihong,MA Juan*   

  1. Department of Gastroenterology,Guangdong General Hospital/Guangdong Academy of Medical Sciences,Guangzhou 510080,China
    *Corresponding author:MA Juan,Associate chief physician,Master supervisor;E-mail:mjlqh@163.com
  • Published:2018-10-05 Online:2018-10-05

摘要: 目的 探讨急性胰腺炎(AP)合并糖尿病(DM)的临床特点。方法 选取2013—2016年广东省人民医院收治的AP患者329例,根据有无DM病史将其分为单纯AP组249例和AP合并DM组80例。通过查阅病历收集并比较两组患者的性别、年龄、既往病史、病因、三酰甘油(TG)水平、总胆固醇(TC)水平、住院时间、病死率、病情严重程度及评分〔Ranson、急性生理与慢性健康Ⅱ(APACHE-Ⅱ)、急性胰腺炎床旁指数(BISAP)、改良的CT严重指数(MCTSI)〕、并发症发生率。结果 单纯AP组患者既往AP史比例及TG、TC水平低于AP合并DM组,差异有统计学意义(P<0.05);两组患者病因比较,差异有统计学意义(P<0.05);两组患者性别、年龄、住院时间、病死率比较,差异无统计学意义(P>0.05)。两组患者病情严重程度、Ranson、APACHE-Ⅱ、BISAP、MCTSI评分比较,差异无统计学意义(P>0.05)。两组患者急性液体积聚、急性坏死物积聚、胰腺假性囊肿、包裹性坏死、胸腔积液、门静脉栓塞、器官功能衰竭、系统性炎性反应综合征、全身感染、腹腔内高压(IAH)/腹腔间隔室综合征(ACS)发生率比较,差异无统计学意义(P>0.05)。结论 AP合并DM不会增加疾病的严重程度和并发症的发生,对病死率和住院时间也没有明显影响。

关键词: 胰腺炎, 糖尿病, 疾病特征

Abstract: Objective  To investigate the clinical characteristics of acute pancreatitis(AP) among patients with diabetes mellitus(DM).Methods We enrolled 329 cases of AP from Guangdong General Hospital from 2013 to 2016,including 80 with a history of DM(DM with AP group)and 249 without(simple AP group). Based on reviewing the medical records,we collected the clinical data about sex,age,past medical history,etiology,levels of triacylglycerol(TG) and total cholesterol(TC),length of stay(LOS),incidence of mortality,severity levels of AP evaluated by the Chinese Guidelines for the Management of Acute Pancreatitis(Shanghai,2013) and severity scores of conditions〔comprehensively evaluated by Ranson's score,APACHE-Ⅱ score,bedside index for severity in acute pancreatitis (BISAP) score,and modified CT severity index(MCTSI)〕,complications and compared them between the groups. Results  Compared with DM with AP group,simple AP group had lower rate of patients with a history of previous pancreatitis,and lower levels of TG and TC(P<0.05). The distribution of etiologies differed significantly between the two groups(P<0.05).However,two groups showed no significant differences in the distribution of sex,age,LOS,mortality,severity levels of AP and severity scores of conditions(assessed by Ranson's score,APACHE-Ⅱscore,BISAP score,and MCTSI),and incidence of the aforementioned local and systemic complications(P>0.05). Conclusion Diabetic status has little effect on the severity of AP,the incidence of local and systemic complications caused by AP,the mortality as well as LOS. 

Key words: Pancreatitis, Diabetes mellitus, Disease attributes