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脂肪肝疾病与急性胰腺炎的严重程度相关:系统评价和荟萃分析。

Fatty liver disease is associated with the severity of acute pancreatitis:A systematic review and meta-analysis.

机构信息

Department of General Surgery, Xuchang Central Hospital, Henan, China.

Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, 201907, China.

出版信息

Int J Surg. 2019 May;65:147-153. doi: 10.1016/j.ijsu.2019.04.003. Epub 2019 Apr 12.

Abstract

BACKGROUND

Fatty liver (FL) has been positively associated with the risk of acute pancreatitis (AP), but whether FL is associated with the severity of AP remains unknown. To this, a meta-analysis was conducted to assess the effect of FL on severity and outcomes of AP.

METHOD

We searched PubMed, EMBASE and the Cochrane library to identify all eligible studies (up to June 2017). We pooled the odds ratios (ORs) or weighted mean differences (WMD) from individual studies using a random-effects model to investigate associations between FL and the prognosis of AP.

RESULT

Four studies were included in the meta-analysis, including a total of 805 patients with fatty liver-related acute pancreatitis (FLAP) and 1026 patients with non fatty liver-related acute pancreatitis (NFLAP). The incidences of moderately severe AP (MSAP) (OR = 2.72, 95%CI: 1.82-4.05, P < 0.001) and severe AP (SAP) (OR = 3.57, 95%CI: 2.06-6.18, P < 0.001) were statistically significantly higher in FLAP group than those in NFLAP group. Taking obesity into consideration, a higher rate of MSAP and SAP were also found in patients with FL, no matter whether they were obese or not. Furthermore, mortality (OR = 4.16, 95%CI: 2.57-6.73, P < 0.001), systemic inflammatory response syndrome (SIRS) (OR = 2.82, 95%CI: 2.3-3.47, P < 0.001) and local complications were also statistically significantly higher in the FLAP group than in NFLAP group.

CONCLUSION

Fatty liver is associated with the severity of acute pancreatitis.

摘要

背景

脂肪肝(FL)与急性胰腺炎(AP)的风险呈正相关,但 FL 是否与 AP 的严重程度相关尚不清楚。为此,进行了一项荟萃分析,以评估 FL 对 AP 严重程度和结局的影响。

方法

我们检索了 PubMed、EMBASE 和 Cochrane 图书馆,以确定所有符合条件的研究(截至 2017 年 6 月)。我们使用随机效应模型从个体研究中汇总比值比(ORs)或加权均数差(WMD),以研究 FL 与 AP 预后之间的关系。

结果

共有 4 项研究纳入荟萃分析,共包括 805 例脂肪肝相关性急性胰腺炎(FLAP)患者和 1026 例非脂肪肝相关性急性胰腺炎(NFLAP)患者。FLAP 组中度重症急性胰腺炎(MSAP)(OR=2.72,95%CI:1.82-4.05,P<0.001)和重症急性胰腺炎(SAP)(OR=3.57,95%CI:2.06-6.18,P<0.001)的发生率明显高于 NFLAP 组。考虑到肥胖因素,无论是否肥胖,FL 患者的 MSAP 和 SAP 发生率也更高。此外,FLAP 组的死亡率(OR=4.16,95%CI:2.57-6.73,P<0.001)、全身炎症反应综合征(SIRS)(OR=2.82,95%CI:2.3-3.47,P<0.001)和局部并发症的发生率也明显高于 NFLAP 组。

结论

脂肪肝与急性胰腺炎的严重程度有关。

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