酒精摄入量是急性酒精性胰腺炎严重程度的重要决定因素。

Amount of alcohol is an important determinant of the severity of acute alcoholic pancreatitis.

作者信息

Jaakkola M, Sillanaukee P, Löf K, Koivula T, Nordback I

机构信息

Department of Clinical Sciences, University of Tampere, Finland.

出版信息

Surgery. 1994 Jan;115(1):31-8.

PMID:8284758

Abstract

BACKGROUND

Does the amount of recently consumed alcohol correlate with the severity of acute alcoholic pancreatitis?

METHODS

One hundred one consecutive episodes of acute pancreatitis (AP) were prospectively studied. Seventy-three were alcoholic AP episodes; 40 patients had their first alcoholic AP episode. A standard personal interview was used to determine the alcohol consumption during 2 months and during 1 week before AP. The severity of AP was evaluated according to the Ranson criteria, the serum C-reactive protein (CRP) concentration measured 24 to 48 hours after admission, the length of the hospital stay, the development of complications, and the mortality rate.

RESULTS

In the 40 patients having their first alcoholic AP episode, the reported 2-month alcohol consumption correlated significantly with the number of positive Ranson criteria (correlation coefficient r = 0.44, p < 0.01), serum CRP concentration (r = 0.51, p < 0.001), and the length of the hospital stay (r = 0.45, p < 0.01). Complications occurred in eight of 14 patients with 2-month alcohol consumption of more than 5000 gm as compared with one of 14 patients with consumption of less than 2000 gm (p < 0.05). In the same 40 patients the 1-week alcohol consumption correlated with the number of positive Ranson criteria (r = 0.40, p < 0.05) and serum CRP concentration (r = 0.37, p < 0.05). Of the 12 patients who had consumed more than 1000 gm alcohol during the last week before admission, two died and complications developed in six (50%), as compared with none (p < 0.05) and six (21%), respectively, of those who had consumed less than 1000 gm. No significant correlations were observed between the reported alcohol consumption and any of the severity parameters in the 33 patients with recurrent episodes of alcoholic AP.

CONCLUSIONS

The amount of alcohol consumed may be an important determinant of the severity of the first alcoholic AP episode but not of recurrent alcoholic AP.

摘要

背景

近期饮酒量与急性酒精性胰腺炎的严重程度是否相关？

方法

对101例连续的急性胰腺炎（AP）发作进行前瞻性研究。其中73例为酒精性AP发作；40例患者为首次酒精性AP发作。通过标准的个人访谈来确定AP发作前2个月及1周内的饮酒量。根据兰森标准、入院后24至48小时测得的血清C反应蛋白（CRP）浓度、住院时间、并发症的发生情况及死亡率来评估AP的严重程度。

结果

在40例首次发生酒精性AP发作的患者中，报告的2个月饮酒量与兰森标准阳性数（相关系数r = 0.44，p < 0.01）、血清CRP浓度（r = 0.51，p < 0.001）及住院时间（r = 0.45，p < 0.01）显著相关。在2个月饮酒量超过5000克的14例患者中有8例发生并发症，而饮酒量少于2000克的14例患者中仅有1例发生并发症（p < 0.05）。在同一40例患者中，1周饮酒量与兰森标准阳性数（r = 0.40，p < 0.05）及血清CRP浓度（r = 0.37，p < 0.05）相关。在入院前最后一周饮酒量超过1000克的12例患者中，2例死亡，6例（50%）发生并发症，而饮酒量少于1000克的患者中分别无死亡（p < 0.05）及6例（21%）发生并发症。在33例复发性酒精性AP发作的患者中，报告的饮酒量与任何严重程度参数之间均未观察到显著相关性。