BACKGROUND:Hypertriglyceridemia is one of the three most common causes of AP, which is associated with the AP prognosis that has not been clearly defined. METHODS:In this retrospective study, 1539 AP patients, who had serum triglyceride (TG) levels measured within the first 72 h, were assessed. The study groups consisted of patients with normal, mild, moderate, and severe/very severe HTG levels based on the Endocrine Society Clinical Practice Guidelines. We collected baseline demographic information, laboratory values, complications, and clinical outcome data in different HTG severity groups to analyze the clinical significance of elevated TG levels in AP. RESULTS:Our study included 1539 AP patients; of these, 1078 (70%) had a normal TG levels, and 461 (30%) had elevated TG levels. The rates of severe AP increased in HTG groups of increasing severity (4% vs. 8% vs. 12%; P trend < 0.001). acute necrotic collection (ANC) and pancreatic necrosis developed in 32 and 39 of 112 patients (29% and 35%) (P trend = 0.001; P trend = 0.001) in the severe/very severe HTG group, respectively. The proportion of persistent organ failure (POF), multiple organ failure (MOF), and persistent Systemic Inflammatory Response Syndrome (SIRS) increased with higher grades of HTG (P trend < 0.001; P trend < 0.001; P trend < 0.001). The ICU admission rate was higher in the severe/very severe HTG group (57/112 patients; 51%; P trend < 0.001). A logistic multivariate regression analysis showed a positive correlation between HTG and certain AP complications. CONCLUSION:In addition to other factors, an elevated TG level could be associated with the severity and prognosis of AP, including pancreatic necrosis, POF, MOF, persistent SIRS, ICU admission, and mortality.

译文

背景:高甘油三酯血症是AP的三种最常见原因之一,与AP的预后相关,目前尚不清楚。
方法:在这项回顾性研究中,评估了1539名在前72小时内测得的血清甘油三酸酯(TG)水平的AP患者。根据内分泌学会临床实践指南,研究组包括正常,轻度,中度和重度/非常重度HTG水平的患者。我们收集了不同HTG严重程度组的基线人口统计学信息,实验室值,并发症和临床结果数据,以分析AP中TG水平升高的临床意义。
结果:我们的研究包括1539例AP患者。其中,1078(70%)的TG水平正常,461(30%)的TG水平升高。在严重程度更高的HTG组中,严重AP的发生率增加(4%vs. 8%vs. 12%; P趋势<0.001)。在重度/非常重度HTG组中,分别有112例患者中的32例和39例发生了急性坏死集合(ANC)和胰腺坏死(29%和35%)(P趋势= 0.001; P趋势= 0.001)。 HTG等级越高,持续性器官衰竭(POF),多器官衰竭(MOF)和持续性系统性炎症反应综合征(SIRS)的比例越高(P趋势<0.001; P趋势<0.001; P趋势<0.001)。重度/非常重度HTG组的ICU入院率更高(57/112例患者; 51%; P趋势<0.001)。 Logistic多元回归分析显示,HTG与某些AP并发症之间呈正相关。
结论:除其他因素外,TG水平升高可能与AP的严重程度和预后相关,包括胰腺坏死,POF,MOF,持续SIRS,ICU入院和死亡率。

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