Iskandar Said B, Olive Kenneth E
Department of Internal Medicine, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614, USA.
Am J Med Sci. 2004 Nov;328(5):290-4. doi: 10.1097/00000441-200411000-00010.
Hypertriglyceridemia is an uncommon cause of pancreatitis. A serum triglyceride level of more then 1000 to 2000 mg/dL is an identifiable risk factor. Interestingly, serum pancreatic enzyme levels may be normal or only minimally elevated in such cases. The reduction of triglyceride level to below 1000 mg/dL effectively prevents further episodes of pancreatitis. The mainstay of treatment for the hypertriglyceridemia associated with pancreatitis includes dietary restriction of fat and administration of lipid-lowering agents. It is thought that within 24 to 48 hours of the onset of pancreatitis, in the majority of patients, triglyceride levels fall rapidly as a result of fasting status, as the absorption of chylomicrons to the blood is cut off. Experiences with plasmapheresis are limited. We report a case of hypertriglyceridemic necrotizing pancreatitis with mildly elevated amylase and lipase, treated successfully with plasmapheresis.
高甘油三酯血症是胰腺炎的一种罕见病因。血清甘油三酯水平超过1000至2000mg/dL是一个可识别的风险因素。有趣的是，在这种情况下，血清胰酶水平可能正常或仅轻微升高。将甘油三酯水平降至1000mg/dL以下可有效预防胰腺炎的进一步发作。与胰腺炎相关的高甘油三酯血症的主要治疗方法包括饮食限制脂肪和使用降脂药物。据认为，在胰腺炎发作后的24至48小时内，大多数患者由于禁食状态，乳糜微粒向血液中的吸收被切断，甘油三酯水平会迅速下降。血浆置换的经验有限。我们报告一例高甘油三酯血症性坏死性胰腺炎患者，淀粉酶和脂肪酶轻度升高，经血浆置换成功治疗。
