高甘油三酯血症性胰腺炎的全血浆置换：病例报告及文献综述
Total Plasma Exchange in Hypertriglyceridemia-Induced Pancreatitis: Case Report and Literature Review.
作者信息
Dehal Harleen, Adashek Michael
机构信息
Department of Internal Medicine, Sinai Hospital, Baltimore, MD, USA.
出版信息
Case Rep Med. 2018 Mar 4;2018:4017573. doi: 10.1155/2018/4017573. eCollection 2018.
OBJECTIVE
To emphasize the role of apheresis in management of pancreatitis.
METHODS
The clinical course of a patient admitted for hypertriglyceridemia-induced pancreatitis (HTGP) complicated by multiorgan dysfunction is described, who demonstrated dramatic improvement in his clinical status after total plasma exchange (TPE). In addition, the current guidelines for TPE and the alternative treatment options for HTGP are also presented.
RESULTS
A patient presenting with pancreatitis associated with severe systemic inflammatory response was admitted to our hospital with an initial triglyceride level of 1181 mg/dL. Given the patient's worsening clinical condition, he was started on TPE with a rapid fall in his serum TG levels, in turn leading to early clinical recovery.
CONCLUSION
Though various therapeutic options for the treatment of HTGP are described in literature, there are no set guidelines available to tackle this difficult clinical situation. TPE, albeit not very well known in this context, is one of the many therapies available. Though it leads to a rapid, precipitous fall in the TG levels and early symptom resolution, the data about the long-term morbidity as well as the effectiveness of this therapy is still lacking.
目的
强调血液成分单采术在胰腺炎治疗中的作用。
方法
描述了一名因高甘油三酯血症性胰腺炎（HTGP）合并多器官功能障碍入院患者的临床病程，该患者在进行全血浆置换（TPE）后临床状况显著改善。此外，还介绍了当前TPE的指南以及HTGP的替代治疗方案。
结果
一名患有与严重全身炎症反应相关胰腺炎的患者入院，初始甘油三酯水平为1181mg/dL。鉴于患者临床状况恶化，开始对其进行TPE治疗，其血清甘油三酯水平迅速下降，进而实现早期临床康复。
结论
尽管文献中描述了治疗HTGP的各种治疗选择，但尚无既定指南来应对这一困难的临床情况。TPE在此背景下虽不太为人所知，但却是可用的多种疗法之一。尽管它能使甘油三酯水平迅速、急剧下降并使症状早期缓解，但仍缺乏关于该疗法长期发病率及有效性的数据。
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