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双重滤过血浆置换治疗高脂血症性急性胰腺炎的疗效:一项回顾性观察研究。

Efficacy of double filtration plasmapheresis in hyperlipidemia acute pancreatitis: a retrospective observational study.

作者信息

Qin Rong, Liu Yibei, Ding Rui, Yang Minhui, Huang Yun, Chen Xujia, Zhang Feng, Liu Yanting, Jia Hongping, Duan Yiyao, Zhou Lifang, Wang Hui

机构信息

Department of Gastroenterology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, Yunnan, 650051, China.

Key Laboratory of Tumor Immunological Prevention and Treatment of Yunnan Province, Kunming, 650051, China.

出版信息

Lipids Health Dis. 2025 Jan 27;24(1):27. doi: 10.1186/s12944-025-02448-2.

DOI:10.1186/s12944-025-02448-2
PMID:39871253
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11773909/
Abstract

BACKGROUND

This study examines the role and effectiveness of double filtration plasmapheresis (DFPP) in managing hyperlipidemiclipidemic acute pancreatitis (HLAP).

METHODS

Comparative analysis was conducted between two groups: one treated with DFPP and one without. Comparative parameters included blood lipid levels, inflammatory factors, vital signs, disease severity scores, and complication rates.

RESULTS

A total of 97 HLAP patients were included in the study. Within-group analysis revealed significant pre- and post-treatment changes in total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), white blood cell count (WBC), neutrophil percentage (N%), systemic immune-inflammation index (SII), mean arterial pressure (MAP), bedside index for severity in acute pancreatitis (BISAP), and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores in the DFPP group (P < 0.05). In contrast, the without DFPP group showed significant changes in TC, TG, LDL-C, WBC, N%, SII, systemic inflammation response index (SIRI), panimmune-inflammation value (PIV), respiration rate (RR), and APACHE II scores (P < 0.05). Significant differences in TC, TG, HDL-C, LDL-C, and RR were found between the DFPP and without DFPP groups (P < 0.05). The DFPP group exhibited greater reductions in TG levels and more individual variability. In terms of complications, the rate of systemic inflammatory response syndrome (SIRS) differed significantly between the groups (P < 0.05).

CONCLUSIONS

DFPP can significantly improve short-term outcomes, reduce lipid levels, and reduce the incidence of complications such as SIRS in HLAP patients compared with those not receiving DFPP treatment. The clinical utility of DFPP is considerable, and further exploration and implementation of this method are warranted.

摘要

背景

本研究探讨双重滤过血浆置换(DFPP)在治疗高脂血症性急性胰腺炎(HLAP)中的作用及疗效。

方法

对两组患者进行对比分析:一组接受DFPP治疗,另一组未接受。对比参数包括血脂水平、炎症因子、生命体征、疾病严重程度评分及并发症发生率。

结果

本研究共纳入97例HLAP患者。组内分析显示,DFPP组治疗前后总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、白细胞计数(WBC)、中性粒细胞百分比(N%)、全身免疫炎症指数(SII)、平均动脉压(MAP)、急性胰腺炎严重程度床边指数(BISAP)及急性生理与慢性健康状况评分系统II(APACHE II)评分有显著变化(P < 0.05)。相比之下,未接受DFPP组在TC、TG、LDL-C、WBC、N%、SII、全身炎症反应指数(SIRI)、全免疫炎症值(PIV)、呼吸频率(RR)及APACHE II评分方面有显著变化(P < 0.05)。DFPP组与未接受DFPP组在TC、TG、HDL-C、LDL-C及RR方面存在显著差异(P < 0.05)。DFPP组TG水平降低幅度更大,个体差异也更大。在并发症方面,两组全身炎症反应综合征(SIRS)发生率差异有统计学意义(P < 0.05)。

结论

与未接受DFPP治疗的HLAP患者相比,DFPP可显著改善短期预后,降低血脂水平,并降低SIRS等并发症的发生率。DFPP具有相当大的临床应用价值,值得进一步探索和应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/894a/11773909/e81e63760a0c/12944_2025_2448_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/894a/11773909/44c0c9e34d16/12944_2025_2448_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/894a/11773909/e81e63760a0c/12944_2025_2448_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/894a/11773909/44c0c9e34d16/12944_2025_2448_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/894a/11773909/e81e63760a0c/12944_2025_2448_Fig2_HTML.jpg

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本文引用的文献

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Lipids Health Dis. 2024 Mar 8;23(1):70. doi: 10.1186/s12944-024-02057-5.
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Evaluating the efficacy and timing of blood purification modalities in early-stage hyperlipidemic acute pancreatitis treatment.评价早期高脂血症性急性胰腺炎治疗中血液净化方式的疗效和时机。
Lipids Health Dis. 2023 Nov 29;22(1):208. doi: 10.1186/s12944-023-01968-z.
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Clinical value of BISAP score combined with CRP and NLR in evaluating the severity of acute pancreatitis.
BISAP 评分联合 CRP 和 NLR 在评估急性胰腺炎严重程度中的临床价值。
Medicine (Baltimore). 2023 Nov 10;102(45):e35934. doi: 10.1097/MD.0000000000035934.
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Intravenous Insulin in Hypertriglyceridemic Pancreatitis.静脉内胰岛素在高三酰甘油血症性胰腺炎中的应用。
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Systemic Inflammation Response Index and Systemic Immune Inflammation Index Are Associated with Clinical Outcomes in Patients with Acute Pancreatitis?全身炎症反应指数和全身免疫炎症指数与急性胰腺炎患者的临床结局有关吗?
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Global Incidence of Acute Pancreatitis Is Increasing Over Time: A Systematic Review and Meta-Analysis.全球急性胰腺炎发病率随时间推移呈上升趋势:一项系统评价和荟萃分析。
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