酒精性急性胰腺炎的临床及预后特征分析

蒋鑫; 徐欢; 严永峰; 钟瑞; 罗旭娟; 史孝敏; 汪敏; 彭燕; 汤小伟

doi:10.3969/j.issn.1001-5256.2019.11.027

酒精性急性胰腺炎的临床及预后特征分析

DOI: 10.3969/j.issn.1001-5256.2019.11.027

1. 西南医科大学附属医院消化内科
2. 西南医科大学附属医院临床营养科

基金项目:

泸州市科技局基金(17246)；泸州市三方联合基金(Z1437)；

详细信息

中图分类号: R576
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出版历程
- 收稿日期: 2019-07-15
- 出版日期: 2019-11-20

Clinical and prognostic features of acute alcoholic pancreatitis

Department of Gastroenterology,The Affiliated Hospital of Southwest Medical University

Research funding:

摘要

摘要: 目的探讨酒精性急性胰腺炎患者的临床及预后特征。方法选取2013年7月-2018年7月西南医科大学附属医院收治的467例初发急性胰腺炎（AP）患者为研究对象,其中包括182例酒精性AP患者（酒精组）,与同期285例胆源性AP患者（胆道组）,分析两组患者的临床特点,包括年龄、性别、实验室指标、病情分级、并发症、预后指标等。符合正态分布的计量资料两组间比较采用独立样本t检验;不符合正态分布的计量资料两组间比较采用Mann-Whitney U检验。计数资料两组间比较采用χ2检验或Fisher精确概率法。等级资料两组间比较采用Mann-Whithey U检验。结果酒精组的男性构成比高于胆道组（74. 2%vs48. 1%）（χ2=31. 124,P <0. 001）;酒精组伴发脂肪肝的比例高于胆道组（34. 1%vs 24. 9%,χ2=4. 569,P=0. 033）;胆道组伴发高血压的比例高于酒精组（23. 5%vs 15. 4%,χ2=4. 524,P=0. 033）;酒精组患者的肌酐、甘油三酯水...
- 胰腺炎,酒精性 /
- 胆结石 /
- 体征和症状 /
- 预后
Abstract: Objective To investigate the clinical and prognostic features of acute alcoholic pancreatitis. Methods A total of 467 patients with incipient acute pancreatitis( AP) who were admitted to The Affiliated Hospital of Southwest Medical University from July 2013 to July2018 were enrolled as subjects,and among these patients,182 with alcoholic AP were enrolled as alcoholic group and 285 with biliary AP were enrolled as biliary group. The two groups were compared in terms of the clinical features such as age,sex,laboratory markers,disease grade,complications,and prognostic indices. The independent samples t-test was used for comparison of normally distributed continuous data between two groups,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups. The chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups,and the Mann-Whitney U test was used for comparison of ranked data between two groups. Results Compared with the biliary group,the alcoholic group had significantly higher constituent ratio of male patients( 74. 2% vs 48. 1%,χ2= 31. 124,P < 0. 001) and proportion of patients with fatty liver disease( 34. 1% vs 24. 9%,χ2= 4. 569,P = 0. 033). The biliary group had a significantly higher proportion of patients with hypertension than the alcoholic group( 23. 5% vs 15. 4%,χ2= 4. 524,P = 0. 033). Compared with the biliary group,the alcoholic group had significantly higher levels of creatinine and triglyceride( Z =-4. 828,t = 7. 916,both P < 0. 001),proportion of patients with severe AP( 34. 6% vs 15. 1%,Z =-4. 787,P < 0. 001),and CTSI score( 4. 6 ± 1. 7 vs 4. 2 ± 1. 5,t = 2. 672,P = 0. 008). Compared with the biliary group,the alcoholic group had significantly higher probabilities of acute peripancreatic fluid accumulation( 61. 0% vs 49. 8%,χ2=5. 045,P < 0. 05),pancreatic pseudocyst( 11. 5% vs 4. 2%,χ2= 8. 881,P < 0. 05),infectious pancreatic necrosis( 37. 9% vs 19. 6%,χ2= 18. 899,P < 0. 05),and renal failure( 19. 2% vs 8. 4%,χ2= 11. 758,P < 0. 05). Compared with the biliary group,the alcoholic group had significantly longer time to intestinal function recovery,time to relief of abdominal pain,and length of hospital stay( t =-4. 078,-3. 357,and-2. 527,all P < 0. 05). There was a significant difference in mortality rate between the alcoholic group and the biliary group( 7. 1% vs 3. 2%,χ2= 3. 929,P = 0. 047). Conclusion Compared with the biliary group,the alcoholic group has a higher risk of complications,worse clinical manifestations,and a higher mortality rate. Therefore,alcohol abstinence education should be performed for this population,especially men,in order to reduce adverse outcomes.
- pancreatitis,alcoholic /
- cholelithiasis /
- signs and symptoms /
- prognosis

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