Yan Ping, Zhao Hong-Xian, Chen Xia
Department of Gastroenterology, Affiliated Hospital of Southwest Medical University.
Department of Histology and Embryology, Southwest Medical University, Luzhou City, P.R. China.
Medicine (Baltimore). 2020 Oct 23;99(43):e22887. doi: 10.1097/MD.0000000000022887.
Hyperlipemia is a well-established etiology of acute pancreatitis. However, few data are available in the medical literature about the management of triglyceride levels in the outpatient setting in patients with hypertriglyceridemic acute pancreatitis (HTG-AP). We evaluated the blood triglyceride levels and followed the triglyceride management of patients with HTG-AP.This retrospective study enrolled patients with HTG-AP from January 2013 to March 2019 in the Affiliated Hospital of Southwest Medical of University. By reviewing the hospitalization records and the follow-up data, the clinical features, blood triglyceride levels, use of lipid-lowering medications and rate of blood triglyceride levels monitoring after hospital discharge were analyzed.A total of 133 patients (46 women, 87 men; median age at presentation 37.4 years) diagnosed with HTG-AP were enrolled in the study. Thirty-two patients (24.1%) presented with recurrent acute pancreatitis (RAP). Patients who had RAP were younger and had higher blood triglyceride levels than those with a single attack (P < .05). No difference in serum amylase levels, hospitalization duration or mortality rate were observed between non-recurrent acute pancreatitis and RAP patients. Lipid monitoring was only observed in 12.8% of patients and 10 patients (7.5%) took medications to control their blood triglyceride levels after hospital discharge. The follow-up of triglyceride levels in the outpatient setting were higher in RAP patients than in patients with non-recurrent acute pancreatitis (P < .05). Among the patients who measured their triglyceride levels after discharge, 83.3% of patients with RAP had at least 1 follow-up triglyceride level that was higher than 500 mg/dL, while no patients had an HTG-AP attack with a triglyceride level higher than 500 mg/dL.Triglyceride levels after hospital discharge higher than 500 mg/dL may be associated with an increased risk of relapse of clinical acute pancreatitis events. Inappropriate management for triglyceride control in the outpatient setting may be associated with an increased risk of relapse of clinical HTG-AP events.
高脂血症是急性胰腺炎已明确的病因。然而，医学文献中关于门诊环境下高甘油三酯血症性急性胰腺炎（HTG-AP）患者甘油三酯水平管理的数据很少。我们评估了HTG-AP患者的血液甘油三酯水平，并跟踪了其甘油三酯管理情况。这项回顾性研究纳入了2013年1月至2019年3月在西南医科大学附属医院就诊的HTG-AP患者。通过查阅住院记录和随访数据，分析了临床特征、血液甘油三酯水平、降脂药物的使用情况以及出院后血液甘油三酯水平监测率。共有133例诊断为HTG-AP的患者（46例女性，87例男性；就诊时中位年龄37.4岁）纳入研究。32例患者（24.1%）表现为复发性急性胰腺炎（RAP）。与单次发作的患者相比，RAP患者更年轻，血液甘油三酯水平更高（P<0.05）。非复发性急性胰腺炎患者和RAP患者在血清淀粉酶水平、住院时间或死亡率方面未观察到差异。仅12.8%的患者进行了血脂监测，10例患者（7.5%）出院后服用药物控制血液甘油三酯水平。门诊环境下RAP患者的甘油三酯水平随访高于非复发性急性胰腺炎患者（P<0.05）。在出院后测量甘油三酯水平的患者中，83.3%的RAP患者至少有1次随访甘油三酯水平高于500mg/dL，而没有患者因甘油三酯水平高于500mg/dL而发生HTG-AP发作。出院后甘油三酯水平高于500mg/dL可能与临床急性胰腺炎事件复发风险增加有关。门诊环境下甘油三酯控制管理不当可能与临床HTG-AP事件复发风险增加有关。
