The Clinical Features Of Hyperlipidemic Acute Pancreatitis

Objective: With the improvement of people's living standards and the change of dietary pattern, the incidence for hyperlipidemic acute pancreatitis had been rising manifestly in the past more than a dozen years. Today, hyperlipidemia had become the third etiology in acute pancreatitis. Nowadays, hyperlipidemic acute pancreatitis had become the popular topic all over the world, because its own clinical features. This research was a retrospective analysis to investigate the clinical features of hyperlipidemic acute pancreatitis, which was helpful to the prevention and treatment of hyperlipidemic acute pancreatitis.Methods: The medical records of 405 patients, who were admitted to our hospital with first attacks of acute pancreatitis from January 2005 to June 2009, According to etiology, these patients were divided into hyperlipidemic acute pancreatitis group (41 cases) and other pattern of acute pancreatitis group (364 cases). The age, sex, hospital stay, clinical features, laboratory examination, complications and prognosis differences were compared. Statistical analyses were carried out using an SPSS 17.0 statistical package program, unpaired student's t test was used for continuous data (two-tail) when comparing variables between the groups. A nonparametric test was used with skewed distribution of data. Percentage was used to describe enumeration count data, group comparison was analyzed by chisquare test. Significance was assumed when the P value was less than 0.05.Results:1. Incidence: The hyperlipidemic acute pancreatitis constituent ratio was 10.12%. This result was in accord with other reports, and comparing with the hyperlipidemic acute pancreatitis in Guangdong province, there was no significant difference in etiology ratio.2. The clinical features of hyperlipidemic acute pancreatitis: (1) Most of patients were young, the average age was 39.0 years old, and the male ratio was 78.05%, but the male ratio was not different from the female ratio in other pattern of acute pancreatitis. (2) Incidence of fatty liver (65.85%) and diabetes (24.39%) were significantly higher in hyperlipidemic acute pancreatitis group than in other pattern of acute pancreatitis group. (3) The recurrent ratio was 41.46% which was higher in hyperlipidemic acute pancreatitis group than in other pattern of acute pancreatitis group. (4) The mean serum triacylglycerol value in hyperlipidemic acute pancreatitis group was significantly higher than in other pattern of acute pancreatitis group, 82.93% of the serum sample was chylifrom. (5) The elevation of serum amylase was not frequently remarkable in hyperlipidemic acute pancreatitis, and the serum amylase increase less than 3 times in patients with hyperlipidemic acute pancreatitis was 65.85%, the serum amylase less than normal in patients with hyperlipidemic acute pancreatitis was 31.70%.3. The incidence of mild acute pancreatitis, the incidence of severe acute pancreatitis, hospital stay, complications, mortality and urine amylase were no significantly difference between hyperlipidemic acute pancreatitis group and other pattern of acute pancreatitis group.Conclusion:1. Patients with hyperlipidemic acute pancreatitis has younger and remarkable recurrent trend, we should measure the blood lipid in time and control it.2. The mean serum triacylglycerol value in hyperlipidemic acute pancreatitis group was significantly higher and the serum sample was chylifrom.3. Incidence of fatty liver and diabetes were significantly higher in hyperlipidemia. In this case, we should control the blood lipid to prevent acute pancreatitis.4. To reduce the rate of misdiagnosis and missed diagnosis, when the clinical symptoms to prompt acute pancreatitis, but the elevation of serum amylase was not remarkable or normal, we should measure the blood lipid and check the CT of pancreas.