Lloret Linares Célia, Pelletier Anne Laure, Czernichow Sébastien, Vergnaud Anne Claire, Bonnefont-Rousselot Dominique, Levy Philippe, Ruszniewski Philippe, Bruckert Eric
Nutrition, Pitié Salpêtrière Hospital, AP-HP, Paris, France.
Pancreas. 2008 Jul;37(1):13-2. doi: 10.1097/MPA.0b013e31816074a1.
The aim of this study was to assess retrospectively the prevalence and the predictive factors of acute pancreatitis (AP) in a population of patients referred in our endocrinology department for evaluation of very high triglyceride (TG) levels.
One hundred twenty-nine patients (119 with type IV phenotypes and 10 with type V phenotypes according to Fredrickson's classification) were referred to our hospital between 2000 and 2005.
Twenty-six subjects (20.2% of the population) presented with AP. This population was significantly younger at diagnosis of hyperlipidemia (32 vs 40 years, P < 0.001) and at age of investigation (43 vs 48 years, P = 0.05) and had maximum TG levels greater than the population without AP (44.7 vs 24.5, P < 0.001). Subjects of the third tertile of TG levels had a 4.0-fold increased risk (95% confidence interval, 1.3-12.3) of AP compared with the first tertile. Severe pancreatitis (need for intensive care, C-reactive protein >150 mg/L, or Balthazar score >C) was observed in 71.5% of the patients.
Twenty percent of patients with severe hypertriglyceridemia experience at least 1 attack of AP. Pancreatitis seems to occur in young patients at higher levels of TG than previously thought (85% of patients >30 g/L) and is associated with a severe clinical course.
本研究旨在回顾性评估在我院内分泌科因极高甘油三酯（TG）水平而转诊的患者群体中急性胰腺炎（AP）的患病率及预测因素。
2000年至2005年间，129例患者（根据弗雷德里克森分类，119例为IV型表型，10例为V型表型）转诊至我院。
26例患者（占总人群的20.2%）出现AP。该人群在高脂血症诊断时（32岁对40岁，P<0.001）和调查时年龄（43岁对48岁，P = 0.05）显著更年轻，且最大TG水平高于无AP的人群（44.7对24.5，P<0.001）。与TG水平最低三分位数的患者相比，TG水平处于最高三分位数的患者发生AP的风险增加4.0倍（95%置信区间，1.3 - 12.3）。71.5%的患者出现重症胰腺炎（需要重症监护、C反应蛋白>150 mg/L或巴尔萨泽评分>C）。
20%的重度高甘油三酯血症患者至少经历1次AP发作。胰腺炎似乎在比先前认为的更高TG水平（85%的患者>30 g/L）的年轻患者中发生，并且与严重的临床病程相关。
