Lai Tianming, Li Jiarong, Zhou Zhengang, Rao Jingwen, Zhu Yong, Xia Liang, Lei Yupeng, Huang Xin, Ke Huajing, Wu Yao, Liu Pi, Zeng Hao, Xiong Huifang, Luo Lingyu, Chen Youxiang, He Wenhua, Zhu Yin, Lu Nonghua
Department of Gastroenterology, Digestive Disease Hospital, First Affiliated Hospital of Nanchang University, 17 Yong Wai Zheng Street, 330006, Nanchang, Jiangxi, People's Republic of China.
Dig Dis Sci. 2024 Jan;69(1):56-65. doi: 10.1007/s10620-023-08172-0. Epub 2023 Nov 9.
The worldwide incidence of acute pancreatitis (AP) is increasing, but the dominant etiology of AP may vary by country. Mixed etiologies are involved in the increase in the number of AP patients.
This study was to analyze the etiological changes and prognosis of AP patients and explore the prognosis of AP patients with mixed etiologies.
Using a retrospective analysis method, AP patients hospitalized from January 2007 to December 2021 were selected from a pancreatic center in Nanchang, China. Trends in the main etiologies were analyzed, and the severity and prognosis of different etiologies were compared.
A total of 10,071 patients were included. Cholelithiasis (56.0%), hyperlipidemia (25.3%), and alcohol (6.5%) were the top three etiologies. The proportion of acute biliary pancreatitis (ABP) showed a decreasing trend, while the proportion of hypertriglyceridemic pancreatitis (HTGP) and alcoholic AP showed an increasing trend (all p < 0.001). The incidence of organ failure and necrotizing pancreatitis was higher in patients with HTGP than in those with AP induced by other etiologies (all p < 0.05). There was no statistically significant difference in mortality among patients with different etiologies. Patients with AP due to a mixed hypertriglyceridemia-alcoholic etiology had higher ICU admission rates and were more severe than those with AP induced by other mixed etiologies.
In the past 15 years, the proportion of ABP has trended downward, while those of HTGP and alcoholic AP have risen. Among patients with mixed etiologies, those with a mixed hypertriglyceridemia-alcoholic etiology had a worse prognosis.
全球急性胰腺炎（AP）的发病率正在上升，但AP的主要病因可能因国家而异。混合病因与AP患者数量的增加有关。
本研究旨在分析AP患者的病因变化及预后，并探讨混合病因AP患者的预后。
采用回顾性分析方法，选取2007年1月至2021年12月在中国南昌某胰腺中心住院的AP患者。分析主要病因的变化趋势，并比较不同病因的严重程度和预后。
共纳入10071例患者。胆结石（56.0%）、高脂血症（25.3%）和酒精（6.5%）是前三位病因。急性胆源性胰腺炎（ABP）的比例呈下降趋势，而高甘油三酯性胰腺炎（HTGP）和酒精性AP的比例呈上升趋势（均p<0.001）。HTGP患者的器官衰竭和坏死性胰腺炎发生率高于其他病因所致AP患者（均p<0.05）。不同病因患者的死亡率无统计学差异。混合性高甘油三酯血症-酒精性病因所致AP患者的ICU入院率更高，病情比其他混合病因所致AP患者更严重。
在过去15年中，ABP的比例呈下降趋势，而HTGP和酒精性AP的比例有所上升。在混合病因患者中，混合性高甘油三酯血症-酒精性病因患者的预后较差。
