| ObjectiveTo investigate the long-term changes of pancreatic endocrine function of patients with acute pancreatitis through regular follow-up examination.MethodsThe follow-up candidates(52 cases)were selected in the outpatients with acute pancreatitis(AP)clinical recovery and discharge to the hospital from February 2015 to April 2015 in the second affiliated hospital of shanxi medical university,28(53.8%)of men and 24(46.2%)of women.and 40 healthy volunteer people as control group of 25 men(62.5%),15 women(37.5%).Pancreatic endocrine function was tested by fasting serum glucose and 1 hour after meals,2 hours of serum glucose levelsandglycosylated hemoglobin,fasting C peptide and postprandial 1 hour,2 hours C peptide levels,the above indicators were discharged after the patient 3,6,9 months after the measured.At the same time to collect the patient before and after the onset of blood glucose metabolism may affect the relevant clinical data.ResultsIn 52 patients with AP,the average age is 48.4 + 16.7,which classified by the severity of the disease:30 cases of acute edematous pancreatitis(MAP)(57.7%),22 cases of severe acute pancreatitis(SAP)(42.3%).According to the classification of etiology,there were 33 cases of cholinogenous pancreatitis(63.5%),10 cases of alcoholic pancreatitis(19.3%),and 9 cases of hyperlipemia(17.2%).After nine months follow-up,there are 8 cases of DM,10 cases of sugar tolerance abnormality,8 cases of fasting glucose impaired,and 40 healthy controls were in normal range.The AP group had a significant increase in fasting blood glucose and 1,2 hours of post-meal blood sugar compared to the control group(p<0.05).In term of the glycosylated hemoglobin,there was no statistically significant difference between the AP group and the control group.The proportion of patients with abnormal glycemic metabolism(77.27%)in the SAP group was significantly higher than the MAP group(23.23%)(p<0.05).In the patients with hyperlipidemia pancreatitis,blood glucose metabolic abnormalities(87%)compared with gallstone pancreatitis(22%),alcoholic pancreatitis(30%)are more likely to happen to glucose metabolism disorder(P<0.05);In the MAP group,with the extension of follow-up period,the proportion of patients with abnormal glucose metabolism is decreased by the third month of 33%to 23%by 9 months later,pancreatic endocrine function has a tendency to gradually recovery;In the SAP group,there was no reduction in islet function as follow-up time progressed.In this study,acute pancreatitis leads to the pancreatic endocrine function anomality associated risk factors:obesity,long-term drinking(not drinking after disease onset)and hyperlipidemia which is associated with long-term pancreatic endocrine function in patients.Conclusion1.Acute pancreatitis do have a influence in islet function that islet damage severity is closely related to the causes and severity of AP.2.Acute edema pancreatitis can affect the function of the islet in the short term,and as the recovery period extend,the islet function can gradually recover.Acute acute pancreatitis is persistent in the damage to islet function,and most of its patients may develop diabetes mellitus3.Hyperlipidemia pancreatitis is more severe than other types of pancreatitis.The damage to the islet of the biliary pancreatitis and alcoholic pancreatitis is less severe than hyperlipidemia pancreatitis4.Islet disfunction and chronic pancreatitis are the most serious complications resulted from acute pancreatitis.After the onset of alcohol,obesity,hyperlipidemia,patients are more likely to happen islet disfunction.According to different causes and different clinical severity of AP,patients with individualized treatment is of great significance to save the islet function. |
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