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[严重高甘油三酯血症——胰腺炎的一个重要病因]

[Severe hypertriglyceridemia--an important cause of pancreatitis].

作者信息

Graesdal Asgeir

机构信息

Lipidklinikken, Medisinsk avdeling, Rikshospitalet, 0027 Oslo.

出版信息

Tidsskr Nor Laegeforen. 2008 May 1;128(9):1053-6.

Abstract

BACKGROUND

Moderate hypertriglyceridaemia is a risk factor for cardiovascular disease and serious hypertriglyceridaemia, with triglyceride values above 10 mmol/L, increases the risk of pancreatitis. Gallstones and alcohol abuse are regarded as the two most important causes of acute pancreatitis, but the considerable risk posed by hypertriglyceridaemia has probably been underrated. It is therefore crucial to acquire updated knowledge and awareness of the fact that high levels of triglycerides can cause pancreatitis.

MATERIAL AND METHODS

This article is based on current literature retrieved though a search on the topic and clinical experience.

RESULTS AND INTERPRETATION

Serious hypertriglyceridaemia is a relatively rare condition and its usual cause is genetic predisposition combined with obesity, diabetes or alcohol abuse. Certain types of medication, as well as pregnancy, are also well known causes. Current literature suggests that hypertriglyceridaemia is the cause of pancreatitis in 1-38% of the cases--a substantial variation. The condition is often accompanied by low amylase values and may therefore be underrated as a cause. Our case reports illustrate that the etiology is complex. Plasmapheresis or LDL-apheresis may be indicated when conservative treatment proves insufficient.

摘要

背景

中度高甘油三酯血症是心血管疾病的危险因素,而甘油三酯值高于10 mmol/L的严重高甘油三酯血症会增加胰腺炎的风险。胆结石和酗酒被认为是急性胰腺炎的两个最重要病因,但高甘油三酯血症带来的相当大的风险可能被低估了。因此,了解高甘油三酯水平可导致胰腺炎这一事实的最新知识并提高认识至关重要。

材料与方法

本文基于通过对该主题的检索获得的当前文献及临床经验。

结果与解读

严重高甘油三酯血症是一种相对罕见的病症,其常见病因是遗传易感性与肥胖、糖尿病或酗酒相结合。某些类型的药物以及妊娠也是已知的病因。当前文献表明,高甘油三酯血症在1% - 38%的病例中是胰腺炎的病因——差异很大。这种情况常伴有淀粉酶值偏低,因此作为病因可能被低估。我们的病例报告表明病因很复杂。当保守治疗证明不足时,可能需要进行血浆置换或低密度脂蛋白吸附。

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