Lankisch P G, Schirren C A
Department of Internal Medicine, University of Göttingen, Federal Republic of Germany.
Pancreas. 1990 Sep;5(5):626-9. doi: 10.1097/00006676-199009000-00021.
To evaluate whether obesity is a negative prognostic parameter in the course of acute pancreatitis, we examined 149 patients and divided them into four weight groups. Single (methemalbumin) and multiple (Ranson's signs) prognostic parameters were found to be independent of increased body weight in all groups, although the incidence of patients with more than six Ranson's signs or a positive methemalbumin test was highest in the most obese group. There was also no direct positive correlation between increased body weight and the incidence of mortality and late complications such as pseudocysts and abscesses. However, when compared with patients of normal weight, the obese groups showed a slight increase in the incidence of early complications such as shock and renal insufficiency and a significant increase in respiratory insufficiency necessitating artificial ventilation. Thus, increased body weight was associated with increased incidence of early extrapancreatic complications.
为评估肥胖是否为急性胰腺炎病程中的不良预后参数，我们对149例患者进行了检查，并将他们分为四个体重组。尽管在最肥胖组中，出现六个以上兰森氏征或高铁血红蛋白试验阳性的患者发生率最高，但在所有组中，单一（高铁血红蛋白）和多个（兰森氏征）预后参数均与体重增加无关。体重增加与死亡率以及诸如假性囊肿和脓肿等晚期并发症的发生率之间也没有直接的正相关关系。然而，与正常体重患者相比，肥胖组早期并发症如休克和肾功能不全的发生率略有增加，而需要人工通气的呼吸功能不全发生率则显著增加。因此，体重增加与早期胰腺外并发症的发生率增加有关。
