Clinical Analyses Of Acute Pancreatitis Complicated By Liver Injury

Objective: 1. To investigate the influencing factors on the complicated liver injury in acute pancreatitis (AP); 2. To analyse the association between liver injury and causes of AP; 3. To discuss the association between liver injury and AP severity.Methods: For normal person, the CT attenuation value of liver is above or equal to that of spleen, so the liver to spleen CT attenuation value ratio is above or equal to 1 (L/S≥1). For patients with AP, the ratio is always less than 1 (L/S<1), because of the complicated liver injury. In our study, one hundred and ten patients with AP were divided into L/S<1 group and L/S≥1 group. For these two groups, we analysed age, sex, smoke history, alcohol history, hypertension (HTN) history, diabetes mellitus (DM) history, causes of AP, AP severity and the serum biochemical parameters after admission including ALT, AST, ALP, GGT, TBiL, TG, TC, HDL, LDL, Apo-A1, Apo-B.Results: 1. The median age and the level of ALP in the L/S<1 group were significantly lower compared with the L/S≥1 group (p=0.004; p=0.019). DM morbidity and the serum levels of TG, TC and Apo-B in the L/S<1 group were significantly higher compared with the L/S≥1 group (all p<0.005). Sex, smoke history, alcohol history, HTN history and the serum levels of ALT, AST, GGT, TBiL, HDL, LDL and Apo-A1 did not differ significantly between the two groups. 2. In the L/S<1 group, the incidence of non-biliary severe acute pancreatitis (SAP) was higher than that of biliary SAP, while in the L/S≥1 group, the incidence of biliary SAP was higher than that of non-biliary SAP. 3. AP severity did not differ significantly between the two groups.Conclusion: Youth, DM and high serum levels of TG, TC, Apo-B may be the risk factors of complicated liver injury in AP. The incidence of non-biliary SAP complicated liver injury was higher than that of biliary SAP.