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孕妇重度高甘油三酯血症所致急性胰腺炎的处理是否存在差异?

Are There Differences in the Management of Acute Pancreatitis Cases Due to Severe Hypertriglyceridemia in Pregnant Women?

机构信息

Department of Endocrinology, Medical Faculty, Firat University, Elazig, Turkey.

Department of Gastroenterology, Medical Faculty, Istanbul Medeniyet University, Istanbul, Turkey.

出版信息

Med Sci Monit. 2018 Aug 13;24:5619-5623. doi: 10.12659/MSM.910343.

Abstract

BACKGROUND The aim of this study was to determine the prognosis of severe disease and treatment approaches of both normal and pregnant, especially in patients with severe pancreatitis due to hypertriglyceridemia. MATERIAL AND METHODS We included 30 patients (20 females and 10 males) in this study whose follow-ups and treatments were performed after a diagnosis of hypertriglyceridemia-induced acute pancreatitis between January 2011 and May 2017. Patient personal information, such as age, sex, pre-treatment and post-treatment triglyceride levels, receipt of anti-hyperlipidemic treatments or plasmapheresis, and family history, were collected from hospital records and patient files. Patients with severe pancreatitis history, score, and prognosis were included to increase the value of our study. Mild and moderate cases were excluded. RESULTS The mean age of the patients was 35±6 years. Twenty-four patients (80%) received an anti-hyperlipidemic treatment before their pancreatitis attacks. Plasmapheresis was performed on 8 patients before their pancreatitis attacks. Eighteen patients (60%) had a family history suggesting familial hypertriglyceridemia. Twelve patients (40%) were pregnant. CONCLUSIONS The treatment of hypertriglyceridemia-induced acute pancreatitis was mostly confined to supportive, palliative treatments. However, plasmapheresis is a possible treatment option and should be used in the early stages of this disease. The response to medical treatment and support treatment was better in pregnant patients than in the other patient group, and pregnant patients did not require plasmapheresis.

摘要

背景

本研究旨在确定重症疾病的预后以及常规和妊娠患者(特别是由于高甘油三酯血症引起的重症胰腺炎患者)的治疗方法。

材料和方法

我们纳入了 30 名患者(20 名女性和 10 名男性),这些患者在 2011 年 1 月至 2017 年 5 月期间被诊断为高甘油三酯血症性急性胰腺炎,我们对其进行了随访和治疗。我们从病历和患者档案中收集了患者的个人信息,如年龄、性别、治疗前后的甘油三酯水平、降脂治疗或血浆置换的接受情况以及家族史。纳入患有重症胰腺炎病史、评分和预后的患者,以增加本研究的价值。排除轻度和中度病例。

结果

患者的平均年龄为 35±6 岁。24 名患者(80%)在胰腺炎发作前接受了降脂治疗。8 名患者在胰腺炎发作前接受了血浆置换。18 名患者(60%)有家族性高甘油三酯血症史。12 名患者(40%)怀孕。

结论

高甘油三酯血症性急性胰腺炎的治疗主要局限于支持性、姑息性治疗。然而,血浆置换是一种可能的治疗选择,应在疾病早期使用。与其他患者组相比,妊娠患者对药物治疗和支持治疗的反应更好,且无需进行血浆置换。

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本文引用的文献

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Acute Pancreatitis Due to Hypertriglyceridaemia in Pregnancy.妊娠期高甘油三酯血症所致急性胰腺炎
Turk J Anaesthesiol Reanim. 2015 Apr;43(2):116-8. doi: 10.5152/TJAR.2014.83435. Epub 2015 Feb 5.
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Current knowledge of hypertriglyceridemic pancreatitis.高甘油三酯血症性胰腺炎的当前认知
Eur J Intern Med. 2014 Oct;25(8):689-94. doi: 10.1016/j.ejim.2014.08.008. Epub 2014 Sep 27.
5
Therapeutic apheresis for severe hypertriglyceridemia in pregnancy.妊娠重度高甘油三酯血症的治疗性血液清除。
Arch Gynecol Obstet. 2013 May;287(5):839-43. doi: 10.1007/s00404-013-2786-z. Epub 2013 Mar 12.

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