Negi Nitesh, Mokta Jatinder, Sharma Brij, Sharma Rajesh, Jhobta Anupam, Bodh Vishal, Ranjan Asha
Junior Resident, Deptt. of Medicine.
Professor, Deptt. of Medicine.
J Assoc Physicians India. 2018 Mar;66(3):22-4.
Prospective and population-based studies on the incidence of acute pancreatitis (AP) are lacking. We aimed to determine the incidence, etiology, severity, and outcome of AP.
This was an observational prospective study done on 123 patients with AP during one year period in IGMC, Hospital Shimla. Detailed Clinical history was recorded and examination and lab investigations were done. Severity of AP was assessed using modified Atlanta classification.
In this study, 123 patients were included- 89 men (72.35%) and 34 women (27.65%). Median age of presentation was 42 years. The most common presentation was abdominal pain followed by vomiting. The major etiological groups were as follows: alcohol 73 cases (59.3%), gallstones 40, (35.6%); postendoscopic retrograde cholangio-pancreatography 1 (0.8%), hypertriglyceridemia 3 (2.9%), autoimmune 1 (0.8%) and idiopathic 5 cases (4%). Alcohol was the most common cause of AP and followed by gallstone. Mortality was seen in 7(5.7%) patients. Out of seven patients who died in hospital, 5(71.42%) had severe pancreatitis and 2(28.57%) patients had moderately severe pancreatitis. When compared, patients with BMI ≥25, HCT≥44% and CRP ≥150mg/l had an increased risk of developing a severe form of AP.
Alcohol and gallstones were the most common etiology of AP. HCT, CRP and BMI done at admission are useful predictors of severe pancreatitis.
缺乏关于急性胰腺炎（AP）发病率的前瞻性和基于人群的研究。我们旨在确定AP的发病率、病因、严重程度及预后。
这是一项在西姆拉市IGMC医院对123例AP患者进行的为期一年的观察性前瞻性研究。记录详细的临床病史并进行检查及实验室检测。使用改良的亚特兰大分类法评估AP的严重程度。
本研究纳入123例患者，其中男性89例（72.35%），女性34例（27.65%）。中位发病年龄为42岁。最常见的表现是腹痛，其次是呕吐。主要病因分组如下：酒精性73例（59.3%），胆结石40例（35.6%）；内镜逆行胰胆管造影术后1例（0.8%），高甘油三酯血症3例（2.9%），自身免疫性1例（0.8%），特发性5例（4%）。酒精是AP最常见的病因，其次是胆结石。7例（5.7%）患者死亡。在院内死亡的7例患者中，5例（71.42%）患有重症胰腺炎，2例（28.57%）患有中度重症胰腺炎。相比之下，体重指数（BMI）≥25、血细胞比容（HCT）≥44%和C反应蛋白（CRP）≥150mg/l的患者发生重症AP的风险增加。
酒精和胆结石是AP最常见的病因。入院时检测的HCT、CRP和BMI是重症胰腺炎的有用预测指标。
