Sheng Chengcheng, Wang Ying, Xu Zongxu, Wang Jun
Department of Obstetrics and Gynecology, Shengjing Affiliated Hospital of China Medical University, Shenyang City, Liaoning Province, People's Republic of China.
Risk Manag Healthc Policy. 2021 Aug 5;14:3209-3222. doi: 10.2147/RMHP.S318879. eCollection 2021.
PURPOSE: Previous studies indicated that the serum triglyceride level in patients with acute pancreatitis positively correlated with the severity of the disease among the general population. Despite the physiological hypertriglyceridemia in pregnant women, there are no reports on the relationship between serum triglyceride level and the severity of acute pancreatitis in pregnant (APIP) women. This study explores the relationship between serum triglyceride levels and the severity of APIP. PATIENTS AND METHODS: Clinical information of APIP patients admitted to the Shengjing Affiliated Hospital of China Medical University was gathered from January 2012 to December 2020 to conduct retrospective research. The participating patients were divided into mild, moderately severe, and severe acute pancreatitis. The clinical outcomes of patients with different serum triglyceride levels (0-2.3 mmol/L, 2.23-5.65 mmol/L, 5.65-11.2 mmol/l, ≥11.2 mmol/L) were analyzed by performing ordinal logistic regression analysis. Receiver operating curve analysis was used to calculate the threshold value of serum triglyceride concentration that can effectively predict the occurrence of severe acute pancreatitis (SAP). RESULTS: Hypertriglyceridemic acute pancreatitis (HTG-AP) occurred in 47% of APIP patients within the group, with a high prevalence among the Han population. In the present study, the serum triglyceride concentration correlated positively with the severity of APIP (r=0.403, < 0.05). The adjusted logistic model demonstrated that relative to nominal triglyceride levels, the OR value of SAP were 1.036 (95% CI: 0.401-2.677), 3.429 (95% CI: 1.269-9265), 8.329 (95% CI: 3.713-18.682) with triglyceride at the level of 2.23-5.65 mmol/L, 5.65-11.2 mmol/l and ≥11.2 mmol/L. In APIP patients, a triglyceride concentration of 10.7mmol/L or more upon admission was a predictive value for the occurrence of SAP, with a sensitivity of 0.72 and a specificity of 0.65, AUC: 0.708 (95% CI: 0.620-0.796). CONCLUSION: As the serum triglyceride level upon admission increased, the frequency of local and systemic complications increased significantly.
目的：既往研究表明，在普通人群中，急性胰腺炎患者的血清甘油三酯水平与疾病严重程度呈正相关。尽管孕妇存在生理性高甘油三酯血症，但尚无关于血清甘油三酯水平与妊娠合并急性胰腺炎（APIP）患者急性胰腺炎严重程度之间关系的报道。本研究旨在探讨血清甘油三酯水平与APIP严重程度之间的关系。 患者与方法：收集2012年1月至2020年12月在中国医科大学附属盛京医院住院的APIP患者的临床资料，进行回顾性研究。将参与研究的患者分为轻度、中度重症和重症急性胰腺炎。通过有序逻辑回归分析，分析不同血清甘油三酯水平（0 - 2.3 mmol/L、2.23 - 5.65 mmol/L、5.65 - 11.2 mmol/L、≥11.2 mmol/L）患者的临床结局。采用受试者工作特征曲线分析，计算能有效预测重症急性胰腺炎（SAP）发生的血清甘油三酯浓度阈值。 结果：该组APIP患者中47%发生了高甘油三酯血症性急性胰腺炎（HTG - AP），在汉族人群中患病率较高。在本研究中，血清甘油三酯浓度与APIP严重程度呈正相关（r = 0.403，P < 0.05）。校正后的逻辑模型显示，相对于标称甘油三酯水平，甘油三酯水平在2.23 - 5.65 mmol/L、5.65 - 11.2 mmol/L和≥11.2 mmol/L时，SAP的OR值分别为1.036（95%CI：0.401 - 2.677）、3.429（95%CI：1.269 - 9.265）、8.329（95%CI：3.713 - 18.682）。在APIP患者中，入院时甘油三酯浓度≥10.7 mmol/L对SAP的发生具有预测价值，敏感性为0.72，特异性为0.65，AUC：0.708（95%CI：0.620 - 0.796）。 结论：随着入院时血清甘油三酯水平升高，局部和全身并发症的发生率显著增加。
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