Clinical Characteristics Analysis Of 44 Cases Of Hyperlipidemic Acute Pancreatitis

Objectives To summarize the clinical characteristics of HLAP by comparing the clinical data of hyperlipidemia acute pancreatitis and biliary acute pancreatitis,and provide guidance for diagnosis,severity assessment and prognosis judgment of HLAP.Methods According to the inclusion criteria and eliminate criteria,135 acute pancreatitis patients who were diagnosed in the General Hospital of Ningxia Medical University in January 2013-January 2016 were selected,and according to the cause of disease,all the patients were divided into two groups,44 of which were diagnosed as hyperlipidemia acute pancreatitis(HLAP)and 91 patients were diagnosed as biliary acute pancreatitis(ABP).Then,all HLAP patients were divided into two subgroups further,19 patients were diagnosed as severe acute pancreatitis(HL-SAP)and 25 patients were diagnosed as mild acute pancreatitis(HL-MAP).The general information,laboratory indicators,imaging examinations,complication,outcome of all AP patients within 24 hours and untreated after admission were collected,then all the data were analyzed by statistical treatment.Results(1)Compared with ABP group,both the proportion of male patients and BMI in HLAP group were significantly higher than those in ABP group,and the mean age of onset was significantly lower than that of ABP group.All the differences were very significant(P<0.05).The proportion of average length of stay in HLAP group was higher than those in ABP group.But it had not a significant difference(P>0.05).(2)The levels of AMY,TBIL,ALT and AST in HLAP group were all significantly lower than those of ABP group(P =0.000).The levels of PBLC,TG,TC and Glu in HLAP group were all significantly higher than those in ABP group(P <0.05).(3)The proportion of HLAP groupwith diabetes,fatty liver,obesity,pleural effusion and pulmonary infection was significantly higher than that of ABP group(P <0.05),however,the proportion of hypertension was significantly lower than that of ABP group(P <0.05).There were no significant differences between the two groups in regard to the complications of pancreatic necrosis,multiple organ dysfunction,sepsis,pancreatic pseudocyst,peritoneal effusion and pelvic fluid(P> 0.05).(4)Comparation between before treatment and after treatment:in the HLAP group,the level of TG after treatment was significantly lower than that before treatment(P = 0.000),the level of ALT and AST did not change significantly(P> 0.05).In the ABP group,the levels of ALT and AST were significantly decreased after treatment(P <0.05),while the level of TG did not change significantly(P = 0.245).(5)The proportion of diabetes,pleural effusion,peritoneal effusion and pulmonary infection in HL-SAP group were significantly higher than those of HL-MAP group(P <0.05).but there was no significant difference in hypertension,fatty liver and obesity between two groups(P> 0.05).(6)The area under ROC curve(AUC)of pleural effusion of HL-SAP was 0.729.It indicated that the pleural effusion has a batter predictive value for SAP.Conclusion(1)HLAP is more frequent in adolescent males and the AMY is not obvious.(2)Most of the HLAP patients suffer from serious lipid metabolism and glucose metabolism disorders,and they are often accompanied by diabetes,fatty liver and obesity,and also easy to be complicate with a variety of local or systemic complications.(3)ABP group was more easily complicated by liver damage,and easier to recover after treatment than HLAP group.(4)Pleural effusion has an obvious advantages in predicting HL-SAP.