Mikolasevic I, Milic S, Orlic L, Poropat G, Jakopcic I, Franjic N, Klanac A, Kristo N, Stimac D
Department of Gastroenterology, UHC Rijeka, Croatia.
Department of Gastroenterology, UHC Rijeka, Croatia.
Eur J Intern Med. 2016 Jul;32:79-83. doi: 10.1016/j.ejim.2016.04.004. Epub 2016 May 4.
The aim of our study was to investigate the influence of metabolic syndrome on the course of acute pancreatitis determined by disease severity, the presence of local and systemic complications and survival rate.
609 patients admitted to our hospital in the period from January 1, 2008 up to June 31, 2015 with the diagnosis of acute pancreatitis were analyzed. The diagnosis and the severity of acute pancreatitis were made according to the revised Atlanta classification criteria from 2012.
Of 609 patients with acute pancreatitis, 110 fulfilled the criteria for metabolic syndrome. Patients with metabolic syndrome had statistically significantly higher incidence of moderately severe (38.2% vs. 28.5%; p=0.05) and severe (22.7% vs. 12.8%; p=0.01) acute pancreatitis in comparison to those without metabolic syndrome, while patients without metabolic syndrome had higher incidence of mild acute pancreatitis in comparison to those patients with metabolic syndrome (58.7% vs. 39.1%; p<0.001). Patients with metabolic syndrome had a higher number of local and systemic complications, and higher APACHE II score in comparison to patients without metabolic syndrome. In multivariable logistic regression analysis, the presence of metabolic syndrome was independently associated with moderately severe and severe acute pancreatitis. Comparing survival rates, patients suffering from metabolic syndrome had a higher death rate compared to patients without metabolic syndrome (16% vs. 4.5%; p<0.001).
The presence of metabolic syndrome at admission portends a higher risk of moderately severe and severe acute pancreatitis, as well as higher mortality rate.
本研究旨在探讨代谢综合征对急性胰腺炎病程的影响，该病程由疾病严重程度、局部和全身并发症的存在情况以及生存率决定。
分析了2008年1月1日至2015年6月31日期间我院收治的609例诊断为急性胰腺炎的患者。根据2012年修订的亚特兰大分类标准对急性胰腺炎进行诊断和评估严重程度。
609例急性胰腺炎患者中，110例符合代谢综合征标准。与无代谢综合征的患者相比，代谢综合征患者中度严重（38.2%对28.5%；p=0.05）和严重（22.7%对12.8%；p=0.01）急性胰腺炎的发生率在统计学上显著更高，而无代谢综合征的患者轻度急性胰腺炎的发生率高于有代谢综合征的患者（58.7%对39.1%；p<0.001）。与无代谢综合征的患者相比，代谢综合征患者的局部和全身并发症数量更多，急性生理与慢性健康状况评分系统II（APACHE II）评分更高。在多变量逻辑回归分析中，代谢综合征的存在与中度严重和严重急性胰腺炎独立相关。比较生存率，患有代谢综合征的患者死亡率高于无代谢综合征的患者（16%对4.5%；p<0.001）。
入院时存在代谢综合征预示着中度严重和严重急性胰腺炎的风险更高，以及死亡率更高。
