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血浆置换可纠正胰岛素在甘油三酯代谢方面的抵抗——一例高甘油三酯血症性急性胰腺炎病例报告

Plasmapheresis can correct refractoriness of insulin on triglyceride metabolism - A case report of hypertriglyceridemia-induced acute pancreatitis.

作者信息

Sundaram Bala, Pathak Nabadwip, Nanda Sunil Kumar

机构信息

Department of General Medicine, Pondicherry institute of medical sciences, Pondicherry, India.

Department of nephrology, Pondicherry institute of Medical sciences, Pondicherry, India.

出版信息

Arch Clin Cases. 2023 May 22;10(2):70-73. doi: 10.22551/2023.39.1002.10244. eCollection 2023.

Abstract

Hypertriglyceridemia associated acute pancreatitis is a medical emergency and it causes significant morbidity and mortality. Here we report a case of 47 years old male with hypertriglyceridemia associated acute pancreatitis. The diagnosis was confirmed by elevated serum triglyceride levels and elevated lipase levels. Initially, Insulin infusion started with fibrates and statins but due to worsening hypertriglyceridemia and he underwent one session of plasmapheresis, following which triglyceride levels improved. Triglyceride assessment in removed plasma in plasmapheresis showed that the amount of triglyceride level reduction was 4 times the amount removed in plasmapheresis. The study showed that plasmapheresis improves insulin-related triglyceride metabolism besides removal.

摘要

高甘油三酯血症相关性急性胰腺炎是一种医疗急症,会导致严重的发病率和死亡率。在此,我们报告一例47岁男性高甘油三酯血症相关性急性胰腺炎病例。血清甘油三酯水平升高和脂肪酶水平升高证实了诊断。最初,开始胰岛素输注并联合使用贝特类药物和他汀类药物,但由于高甘油三酯血症恶化,他接受了一次血浆置换,之后甘油三酯水平有所改善。血浆置换中去除血浆的甘油三酯评估显示,甘油三酯水平降低的量是血浆置换中去除量的4倍。该研究表明,血浆置换除了能去除甘油三酯外,还能改善胰岛素相关的甘油三酯代谢。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ecc/10201372/be6825b48f6a/acc-10-10244-g001.jpg

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