Coskun Ali, Erkan Nazif, Yakan Savas, Yildirim Mehmet, Carti Erdem, Ucar Deniz, Oymaci Erkan
Department of General Surgery, Izmir Training and Research Hospital, Izmir, Turkey.
Prz Gastroenterol. 2015;10(1):18-22. doi: 10.5114/pg.2014.45412. Epub 2015 Jan 14.
Hypertriglyceridaemia (HT)-induced pancreatitis rarely occurs unless triglyceride levels exceed 1000 mg/dl. Hypertriglyceridaemia over 1,000 mg/dl can provoke acute pancreatitis (AP) and its persistence can worsen the clinical outcome. In contrast, a rapid decrease in triglyceride level is beneficial. Insulin-stimulated lipoprotein lipase is known to decrease serum triglyceride levels. However, their efficacy in HT-induced AP is not well documented.
To present 12 cases of AP successfully treated by insulin administration.
Three hundred and forty-three cases of AP were diagnosed at our clinic between 2005 and 2012. Twelve (3.5%) of these cases were HT-induced AP. Twelve patients who suffered HT-induced AP are reported. Initial blood triglyceride levels were above 1000 mg/dl. Besides the usual treatment of AP, insulin was administered intravenously in continuous infusion. The patients' medical records were retrospectively evaluated in this study.
Serum triglyceride levels decreased to < 500 mg/dl within 2-3 days. No complications of treatment were seen and good clinical outcome was observed.
Our results are compatible with the literature. Insulin may be used safely and effectively in HT-induced AP therapy. Administration of insulin is efficient when used to reduce triglyceride levels in patients with HT-induced AP.
高甘油三酯血症（HT）诱发的胰腺炎很少发生，除非甘油三酯水平超过1000mg/dl。超过1000mg/dl的高甘油三酯血症可引发急性胰腺炎（AP），其持续存在会使临床结局恶化。相比之下，甘油三酯水平迅速下降是有益的。已知胰岛素刺激的脂蛋白脂肪酶可降低血清甘油三酯水平。然而，它们在HT诱发的AP中的疗效尚无充分文献记载。
介绍12例通过胰岛素治疗成功治愈的AP病例。
2005年至2012年期间，我院门诊共诊断出343例AP病例。其中12例（3.5%）为HT诱发的AP。报告了12例HT诱发AP的患者。初始血甘油三酯水平高于1000mg/dl。除了常规的AP治疗外，静脉持续输注胰岛素。本研究对患者的病历进行了回顾性评估。
血清甘油三酯水平在2 - 3天内降至<500mg/dl。未观察到治疗并发症，临床结局良好。
我们的结果与文献相符。胰岛素可安全有效地用于HT诱发的AP治疗。在HT诱发的AP患者中使用胰岛素降低甘油三酯水平是有效的。
