Department of Gastroenterology, Fujian Medical University Union Hospital, Fuzhou, China.
Department of Tuberculosis Ward 2, Wuhan Pulmonary Hospital, Wuhan, China.
Transfusion. 2022 Jan;62(1):72-81. doi: 10.1111/trf.16724. Epub 2021 Nov 4.
The therapeutic effect of plasma exchange (PE) on hypertriglyceridemic acute pancreatitis (HTGAP) is unclear. Therefore, we aimed to explore this therapeutic effect.
This study included 204 patients with HTGAP who underwent treatment at two provincial tertiary grade A hospitals in Fujian Province from October 2012 to May 2021. Patients were divided into a conventional group and a PE group. The Student's t-test and chi-square test were used for data analysis.
Among 204 patients, 56 and 148 were included in the PE and conventional groups, respectively. After propensity score matching (PSM), the PE and conventional groups each had 42 patients. There was no significant difference in age; sex; pregnancy; comorbidities; laboratory findings; incidences of complications, and multiple organ dysfunction syndrome (MODS); organ support treatment; surgical rate; mortality; and hospital stay between the groups (p > 0.05). The total expenses were significantly higher in the PE group than in the conventional group (p < 0.05). There was no statistically significant difference in the times of PE; total volume of PE; incidences of complications, and MODS; organ support treatment; surgical rate; mortality; and hospital stay between the early PE and delayed PE groups (p > 0.05). All patients in the PE group and conventional group with acute renal failure had significantly higher D-dimer levels than those without acute renal failure (p < 0.05).
Compared with conventional treatment, PE does not have a better therapeutic effect on HTGAP. The D-dimer level can predict whether patients with HTGAP will have acute renal failure.
血浆置换(PE)治疗高三酰甘油血症性胰腺炎(HTGAP)的疗效尚不清楚。因此,我们旨在探讨这种治疗效果。
本研究纳入了 2012 年 10 月至 2021 年 5 月在福建省两家省级三甲医院治疗的 204 例 HTGAP 患者。患者分为常规组和 PE 组。采用 Student's t 检验和卡方检验进行数据分析。
在 204 例患者中,PE 组和常规组分别纳入 56 例和 148 例。经过倾向评分匹配(PSM)后,PE 组和常规组各有 42 例患者。两组患者在年龄、性别、妊娠、合并症、实验室检查、并发症和多器官功能障碍综合征(MODS)发生率、器官支持治疗、手术率、死亡率和住院时间方面无统计学差异(p>0.05)。PE 组总费用明显高于常规组(p<0.05)。早期 PE 组和延迟 PE 组在 PE 次数、PE 总容量、并发症和 MODS 发生率、器官支持治疗、手术率、死亡率和住院时间方面无统计学差异(p>0.05)。PE 组和常规组所有急性肾衰竭患者的 D-二聚体水平均明显高于无急性肾衰竭患者(p<0.05)。
与常规治疗相比,PE 对 HTGAP 并无更好的治疗效果。D-二聚体水平可预测 HTGAP 患者是否会发生急性肾衰竭。