血清三酰甘油水平在急性胰腺炎中的升高：一个需要早期测量和考虑的参数。
Elevated Serum Triglyceride Levels in Acute Pancreatitis: A Parameter to be Measured and Considered Early.
机构信息
Universitat Autonoma de Barcelona, Department of Hepato-Pancreato-Biliary and Transplant Surgery, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
Department of Gastroenterology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
出版信息
World J Surg. 2022 Jul;46(7):1758-1767. doi: 10.1007/s00268-022-06533-w. Epub 2022 Mar 30.
BACKGROUND
The value of serum triglycerides (TGs) related to complications and the severity of acute pancreatitis (AP) has not been clearly defined. Our study aimed to analyze the association of elevated levels of TG with complications and the severity of AP.
METHODS
The demographic and clinical data of patients with AP were prospectively analyzed. TG levels were measured in the first 24 h of admission. Patients were divided into two groups: one with TG values of<200 mg/dL and another with TG≥200 mg/dL. Data on the outcomes of AP were collected.
RESULTS
From January 2016 to December 2019, 247 cases were included: 200 with TG<200 mg/dL and 47 with TG≥200 mg/dL. Triglyceride levels≥200 mg/dL were associated with respiratory failure (21.3 vs. 10%, p=0.033), renal failure (23.4 vs. 12%, p=0.044), cardiovascular failure (19.1 vs. 7.5%, p=0.025), organ failure (34 vs. 18.5%, p=0.02), persistent organ failure (27.7 vs. 9.5%, p=0.001), multiple organ failure (19.1 vs. 8%, p=0.031), moderately severe and severe AP (68.1 vs. 40.5%, p=0.001), pancreatic necrosis (63.8 vs. 34%, p<0.001), and admission to the intensive care unit (27.7 vs. 9.5%, p=0.003). In the multivariable analysis, a TG level of≥200 mg/dL was independently associated with respiratory, renal, and cardiovascular failure, organ failure, persistent organ failure, multiple organ failure, pancreatic necrosis, severe pancreatitis, and admission to the intensive care unit (p<0.05).
CONCLUSIONS
In our cohort, TG≥200 mg/dL was related to local and systemic complications. Early determinations of TG levels in AP could help identify patients at risk of complications.
背景
血清甘油三酯（TGs）与急性胰腺炎（AP）的并发症和严重程度的关系尚未明确。本研究旨在分析升高的 TG 水平与 AP 的并发症和严重程度之间的关系。
方法
前瞻性分析了 AP 患者的人口统计学和临床数据。在入院的 24 小时内测量 TG 水平。患者分为两组：一组 TG 值<200mg/dL，另一组 TG≥200mg/dL。收集 AP 结局的数据。
结果
2016 年 1 月至 2019 年 12 月期间，共纳入 247 例患者：200 例 TG<200mg/dL，47 例 TG≥200mg/dL。TG 水平≥200mg/dL 与呼吸衰竭（21.3%比 10%，p=0.033）、肾衰竭（23.4%比 12%，p=0.044）、心血管衰竭（19.1%比 7.5%，p=0.025）、器官衰竭（34%比 18.5%，p=0.02）、持续器官衰竭（27.7%比 9.5%，p=0.001）、多器官衰竭（19.1%比 8%，p=0.031）、中重度和重度 AP（68.1%比 40.5%，p=0.001）、胰腺坏死（63.8%比 34%，p<0.001）和入住重症监护病房（27.7%比 9.5%，p=0.003）相关。多变量分析显示，TG 水平≥200mg/dL 与呼吸、肾和心血管衰竭、器官衰竭、持续器官衰竭、多器官衰竭、胰腺坏死、重度胰腺炎和入住重症监护病房独立相关（p<0.05）。
结论
在本队列中，TG≥200mg/dL 与局部和全身并发症相关。AP 早期测定 TG 水平有助于识别有并发症风险的患者。
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