Furuya Tomoki, Komatsu Masafumi, Takahashi Kenichi, Hashimoto Naoki, Hashizume Takahiro, Wajima Naoki, Kubota Minoru, Itoh Seiji, Soeno Takehiko, Suzuki Kozo, Enzan Keiji, Matsuo Shigeki
Department of Surgery, Akita City Hospital, Akita, Japan.
Ther Apher. 2002 Dec;6(6):454-8. doi: 10.1046/j.1526-0968.2002.00461.x.
We report two cases of hypertriglyceridemic necrotizing pancreatitis treated by plasma exchange (PE). The outcome of each case was quite different according to the timing of PE. A 36 year old man presented with abdominal pain, and a diagnosis of severe acute pancreatitis was made. His serum triglyceride (TG) level was 6,460 mg/dl. He did not undergo PE at first, however, his condition never improved and PE was performed 20 days after the onset of his illness. Finally, he died of multiple organ failure and sepsis. In contrast, a 52 year old man with acute necrotizing pancreatitis was referred to our department. He received PE quickly after hospital admission. His serum TG level, which was 3,540 mg/dl at hospital admission, dramatically returned to normal limits, and he was discharged from the hospital 62 days after admission. The prognosis of severe necrotizing pancreatitis due to hypertriglyceridemia is extremely poor. PE should be applied for the treatment of hypertriglyceridemic necrotizing pancreatitis immediately after its onset.
我们报告了两例采用血浆置换（PE）治疗的高甘油三酯血症性坏死性胰腺炎病例。根据PE治疗的时机，每个病例的结果差异很大。一名36岁男性出现腹痛，被诊断为重症急性胰腺炎。他的血清甘油三酯（TG）水平为6460mg/dl。起初他未接受PE治疗，然而其病情未见好转，在发病20天后进行了PE治疗。最终，他死于多器官功能衰竭和脓毒症。相比之下，一名52岁患有急性坏死性胰腺炎的男性被转诊至我科。入院后他很快接受了PE治疗。他入院时血清TG水平为3540mg/dl，迅速恢复至正常范围，入院62天后出院。高甘油三酯血症所致重症坏死性胰腺炎的预后极差。PE应在高甘油三酯血症性坏死性胰腺炎发病后立即应用于治疗。
