血浆置换在高甘油三酯血症性急性胰腺炎中的作用。

The role of plasma exchange in hypertriglyceridemia-induced acute pancreatitis.

作者信息

Biberci Keskin Elmas, Koçhan Koray, Köker İbrahim H, Gülen Bedia, İnce Ali T, Şentürk Hakan

机构信息

Departments of Gastroenterology.

Emergency Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey.

出版信息

Eur J Gastroenterol Hepatol. 2019 Jun;31(6):674-677. doi: 10.1097/MEG.0000000000001399.

DOI:10.1097/MEG.0000000000001399

PMID:30896552

Abstract

BACKGROUND

Hypertriglyceridemia (HTG)-induced acute pancreatitis (AP) leads to higher morbidity and mortality compared with other etiologies. The role of plasma exchange (PE) in this context is still not well established. We aimed to assess the clinical outcomes of patients with HTG-induced AP who underwent PE and compare it with those who did not.

PATIENTS AND METHODS

We retrospectively evaluated the data of patients who were admitted with HTG-induced AP between January 2013 and May 2018. The endpoint of the study was to assess the clinical outcomes, which included complication rates, mortality, and pancreatitis recurrence rate.

RESULTS

Overall, 41 patients were included in the final analysis. Of these, 12 (29.2%) underwent PE. Patients undergoing PE had more severe pancreatitis on the basis of the Japanese Severity Score [10 (83.3%) vs. 14 (48.3%), P=0.03, respectively). Although mortality was higher in patients who underwent PE [three (25.0%) vs. zero, P<0.01, respectively], there was no difference in terms of complications and recurrence rates. Over a median 21 months of follow-up, 11 (26.8%) patients had recurrent AP.

CONCLUSION

Although PE effectively reduced plasma triglyceride levels, there was no decrease in mortality or recurrences.

摘要

背景

与其他病因相比，高甘油三酯血症（HTG）诱发的急性胰腺炎（AP）导致更高的发病率和死亡率。血浆置换（PE）在这种情况下的作用仍未完全明确。我们旨在评估接受PE的HTG诱发AP患者的临床结局，并将其与未接受PE的患者进行比较。

患者与方法

我们回顾性评估了2013年1月至2018年5月期间因HTG诱发AP入院的患者数据。研究终点是评估临床结局，包括并发症发生率、死亡率和胰腺炎复发率。

结果

总体而言，41例患者纳入最终分析。其中，12例（29.2%）接受了PE。根据日本严重程度评分，接受PE的患者胰腺炎更严重[分别为10例（83.3%）对14例（48.3%），P=0.03]。虽然接受PE的患者死亡率更高[分别为3例（25.0%）对0例，P<0.01]，但在并发症和复发率方面没有差异。在中位21个月的随访中，11例（26.8%）患者出现复发性AP。