Filip Petruta Violeta, Pop Corina Silvia, Diaconu Laura Sorina, Tapu Flori Elena, Tiuca Nicoleta, Mincă Dana Galieta
Chirurgia (Bucur). 2025 Jun;120(3):285-293. doi: 10.21614/chirurgia.3137.
This study aimed to assess and compare the severity of acute pancreatitis (AP) in patients with and without underlying chronic pancreatitis (CP). We included patients diagnosed with AP and categorized them into those with CP and those without CP. Disease severity was defined by the presence of organ failure, intensive care unit (ICU) admission, or mortality. ACP accounted for 25.85% of all AP cases in the study. Patients with ACP were more commonly male smokers with low BMI, lower albumin levels, and higher Balthazar scores. In contrast, patients with AP (without CP) had significantly higher heart rates (HR), Balthazar, and CTSI scores. Length of hospitalization and mortality rate were higher in those patients with AP, who were associated with a high rate of organ dysfunction. Prognostic factors influencing survival at 72 hours were respiratory failure, creatinine/albumin ratio, BISAP, albumin levels, and AKI. Meanwhile, survival at 30 days was influenced by respiratory failure, the creatinine/albumin ratio, and blood urea nitrogen. Compared to AP without CP, ACP is associated with a less severe disease course, lower mortality, reduced organ failure, and shorter ICU stays. However, ACP is more frequently observed in male smokers with lower BMI and albumin and higher CTSI and Balthazar scores.
本研究旨在评估和比较合并或未合并潜在慢性胰腺炎（CP）的急性胰腺炎（AP）患者的病情严重程度。我们纳入了诊断为AP的患者，并将他们分为合并CP组和未合并CP组。疾病严重程度通过是否存在器官衰竭、入住重症监护病房（ICU）或死亡率来定义。在本研究中，合并CP的AP（ACP）占所有AP病例的25.85%。ACP患者更常见于男性吸烟者，其体重指数（BMI）较低、白蛋白水平较低且巴尔萨泽（Balthazar）评分较高。相比之下，AP（未合并CP）患者的心率（HR）、巴尔萨泽和CTSI评分显著更高。AP患者的住院时间和死亡率更高，且与器官功能障碍的高发生率相关。影响72小时生存率的预后因素为呼吸衰竭、肌酐/白蛋白比值、床边指数（BISAP）、白蛋白水平和急性肾损伤（AKI）。同时，30天生存率受呼吸衰竭、肌酐/白蛋白比值和血尿素氮的影响。与未合并CP的AP相比，ACP的病程较轻、死亡率较低、器官衰竭较少且ICU住院时间较短。然而，ACP在BMI和白蛋白较低、CTSI和巴尔萨泽评分较高的男性吸烟者中更常见。
