Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.
Department of Internal Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea; Department of Medicine, Yonsei University Graduate School, Seoul, Republic of Korea.
Pancreatology. 2020 Jun;20(4):617-621. doi: 10.1016/j.pan.2020.03.013. Epub 2020 Mar 31.
Hypertriglyceridemia (HTG) is a well-known cause of acute pancreatitis (AP) and elevation of serum triglycerides (TG) to ≥1000 mg/dl is strongly indicative of HTG-induced AP (HTG-AP). HTG-AP is potentially associated with persistent organ failure and poor prognosis. Here, we compared differences in clinical features and outcomes between patients with HTG-AP and patients with AP due to other causes.
A prospective AP registry was constructed in Gil Medical Center between June 2014 and May 2018. In total, 499 patients with AP were included for whom serum TG data at admission were available.
HTG-AP was present in 52 patients (10.4%); these patients were younger than patients with AP due to other causes (39.62 ± 10.12 vs. 51.62 ± 17.41, p < 0.001). After propensity score matching adjusted by age, the factors associated with severity were more common in the HTG-AP group; these factors included the presence of systemic inflammatory response syndrome, Ranson's score ≥3, acute physiology, age, chronic health evaluation (APACHE) II score ≥8 at admission, and C-reactive protein level >10 mg/dl after 24 h of hospitalization. There were no significant differences in complications or severity based on the revised Atlanta classification 2012. In addition, recurrence was more frequent in the HTG-AP group (25.0% vs. 6.4%, p < 0.001).
HTG-AP occurred in younger patients and showed more frequent recurrences than AP with other causes. Although factors related to severe feature were more common in HTG-AP during early phase, overall severity and prognosis were not different between the two groups.
高甘油三酯血症（HTG）是急性胰腺炎（AP）的已知病因，血清甘油三酯（TG）升高至≥1000mg/dl 强烈提示 HTG 引起的 AP（HTG-AP）。HTG-AP 可能与持续的器官衰竭和不良预后相关。在此，我们比较了 HTG-AP 患者和由其他病因引起的 AP 患者之间的临床特征和结局差异。
我们在 2014 年 6 月至 2018 年 5 月期间在 Gil 医疗中心构建了一项前瞻性 AP 登记研究。共纳入了 499 例 AP 患者，他们入院时的血清 TG 数据可用于研究。
HTG-AP 患者 52 例（10.4%），年龄小于其他病因引起的 AP 患者（39.62±10.12 岁 vs. 51.62±17.41 岁，p<0.001）。经年龄倾向性评分匹配调整后，HTG-AP 组中与严重程度相关的因素更为常见；这些因素包括全身炎症反应综合征、Ranson 评分≥3、急性生理学、年龄、慢性健康评估（APACHE）II 评分≥8、入院后 24 小时 C 反应蛋白水平>10mg/dl。根据 2012 年修订的亚特兰大分类，两组在并发症或严重程度方面无显著差异。此外，HTG-AP 组的复发更为频繁（25.0% vs. 6.4%，p<0.001）。
HTG-AP 发生于年轻患者，且较其他病因引起的 AP 更易复发。虽然在早期阶段 HTG-AP 中更常见与严重程度相关的因素，但两组的总体严重程度和预后无差异。
