Dominguez-Muñoz J E, Malfertheiner P, Ditschuneit H H, Blanco-Chavez J, Uhl W, Büchler M, Ditschuneit H
Department of Internal Medicine II, University of Ulm, Germany.
Int J Pancreatol. 1991 Nov-Dec;10(3-4):261-7.
Serum lipid (triglycerides and cholesterol) concentrations were studied in 49 patients with acute pancreatitis (AP). The aims of the study were to investigate the prevalence of hyperlipidemia (HL) in patients with AP according to etiology and to evaluate whether HL precedes or is a consequence of AP. Moreover, we analyzed the relationship between HL and the development of pancreatic necrosis. At admission, 23 patients (47%) had HL: 9 of 19 patients with alcoholic pancreatitis, 5 of 18 patients with biliary pancreatitis, and 9 of 12 patients with AP of miscellaneous etiologies (p less than 0.05). Severe HL (serum triglycerides greater than 20 mmol/L) was observed in five patients. Serum lipid levels in patients with AP and HL decreased markedly during the first 72 h of evolution, but remained slightly above the upper normal limit in most of them after 15 d. The prevalence of HL was similar in edematous and necrotizing pancreatitis. Necrotizing pancreatitis was significantly associated with the presence of hypertriglyceridemia in conjunction with hypercholesterolemia (p less than 0.05). The observations that a) hyperlipidemia is an early event in acute pancreatitis, (b) serum lipid values decrease during the acute phase of the disease, (c) hyperlipidemia has a different prevalence in different etiologies, and (d) high serum lipid levels are not always associated to pancreatic necrosis suggest that HL is a preexistent metabolic abnormality with respect to AP. On the other hand, HL may play a role in aggravating AP.
对49例急性胰腺炎（AP）患者的血清脂质（甘油三酯和胆固醇）浓度进行了研究。本研究的目的是根据病因调查AP患者中高脂血症（HL）的患病率，并评估HL是先于AP还是AP的结果。此外，我们分析了HL与胰腺坏死发展之间的关系。入院时，23例患者（47%）患有HL：19例酒精性胰腺炎患者中有9例，18例胆源性胰腺炎患者中有5例，12例病因不明的AP患者中有9例（p<0.05）。5例患者出现严重HL（血清甘油三酯大于20 mmol/L）。AP合并HL患者的血清脂质水平在病程的前72小时显著下降，但15天后大多数患者仍略高于正常上限。水肿性胰腺炎和坏死性胰腺炎中HL的患病率相似。坏死性胰腺炎与高甘油三酯血症合并高胆固醇血症显著相关（p<0.05）。以下观察结果：a）高脂血症是急性胰腺炎的早期事件；b）疾病急性期血清脂质值下降；c）不同病因的高脂血症患病率不同；d）高血清脂质水平并不总是与胰腺坏死相关，提示HL是相对于AP而言预先存在的代谢异常。另一方面，HL可能在加重AP方面起作用。
