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急性胰腺炎的基线严重程度和病因学参数:一项描述性横断面分析。

Baseline severity and etiology parameters in acute pancreatitis: A descriptive cross-sectional analysis.

作者信息

Barrera Juana Valentina, Shah Jimmy, Vivian Elaina, Tarnasky Paul R

机构信息

University of California-San Francisco School of Medicine, University of California-San Francisco, San Francisco, CA.

Methodist Digestive Institute, Methodist Dallas Medical Center, Dallas, TX.

出版信息

Medicine (Baltimore). 2025 Sep 5;104(36):e43738. doi: 10.1097/MD.0000000000043738.

Abstract

Rapidly identifying acute pancreatitis (AP) patients at higher risk of developing severe AP (SAP) can help clinicians better direct medical treatment and management. Therefore, we examined clinical parameters and laboratory markers in patients with different etiologies and severities of AP. Demographic, clinical characteristics, and laboratory data were collected from electronic medical records of adult patients with AP and admitted to 1 healthcare system between 2015 and 2021. AP severity was determined using the revised Atlanta classification. The association between biomarkers and outcomes was assessed using exploratory data analyses. Patients with SAP were older than those with mild AP (58.3 (20.2) vs 48.1 (17.5) years, P = .002). Acute biliary pancreatitis predominantly affected women (66%) and Hispanic individuals (51%). Acute alcoholic pancreatitis predominantly affected men (72%) and Black individuals (53%). For patients with acute biliary pancreatitis and pancreatitis of other etiologies, creatinine was the most significant predictor of pancreatitis severity. Patients with hypertriglyceridemia-associated AP were younger (mean (SD): 41.1 (11.9) years, P < .001) and had a higher white blood cell count (14.2 × 103 cells/µL, P < .001). Distinct clinical features and indicators are indicative of mild AP and SAP. Etiology-specific patterns can aid in identifying individuals at high risk of SAP.

摘要

快速识别有发展为重症急性胰腺炎(SAP)更高风险的急性胰腺炎(AP)患者,有助于临床医生更好地指导医疗治疗和管理。因此,我们研究了不同病因和严重程度的AP患者的临床参数和实验室指标。从2015年至2021年期间入住1个医疗系统的成年AP患者的电子病历中收集人口统计学、临床特征和实验室数据。AP严重程度采用修订的亚特兰大分类法确定。使用探索性数据分析评估生物标志物与结局之间的关联。SAP患者比轻症AP患者年龄更大(58.3(20.2)岁对48.1(17.5)岁,P = 0.002)。急性胆源性胰腺炎主要影响女性(66%)和西班牙裔个体(51%)。急性酒精性胰腺炎主要影响男性(72%)和黑人个体(53%)。对于急性胆源性胰腺炎和其他病因的胰腺炎患者,肌酐是胰腺炎严重程度的最显著预测指标。高甘油三酯血症相关性AP患者更年轻(平均(标准差):41.1(11.9)岁,P < 0.001),白细胞计数更高(14.2×10³个细胞/微升,P < 0.001)。不同的临床特征和指标可提示轻症AP和SAP。病因特异性模式有助于识别SAP高危个体。

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