Analysis Of Clinical Features Of Hyperlipidemic Pancreatitis

Objective: With the improvement of people's living standards,the incidence of metabolic syndrome has increased year by year,the incidence of pancreatitis caused by hyperlipidemia is significantly increased.clinically high-lipemia acute pancreatitis,acute pancreatitis clinically refers to pancreatic enzyme activation due to various reasons,pancreatic local sterility An idiopathic disease with enhanced inflammatory conditions,which can be accompanied by systemic multiple organ dysfunction.After the onset of hyperlipidemic pancreatitis,the patient is in a state of increased systemic stress response and impaired islet function.With the deepening of basic and clinical research,hyperlipidemia pancreatitis is a complex disease involving various factors,effectively clarifying the pathogenesis of this disease,reducing risk factors,and actively exploring high-efficiency treatment methods for hyperlipidemia.Intervention and treatment of the mechanism of occurrence and development of pancreatitis can better judge the condition in clinical work,formulate a sound treatment strategy,increase the cure rate,and improve the prognosis of patients.This study retrospectively analyzed the clinical data of patients with hyperlipidemia acute pancreatitis admitted to Huangshan People's Hospital from January 2018 to December 2018,and admitted to hospital for biliary pancreatitis.(BP)patient data were compared to explore the clinical features of hyperlipidemia-associated pancreatitis(HLP)and to improve the diagnosis and treatment of hyperlipemia-related pancreatitis.Methods:40 cases of hyperlipidemic pancreatitis and biliary pancreatitis diagnosed in Huangshan People's Hospital from January 2018 to December 2018 were collected and divided into hyperlipidemic pancreatitis group and biliary pancreatitis group.The medical history data of the two groups were analyzed retrospectively.The admission criteria were in accordance with the diagnostic and therapeutic criteria for severe acute pancreatitis(biliary and hyperlipidemia)of the Pancreatic Surgery Group of the Surgical Society of the Chinese Medical Association in 2010.The age ranges from 18 to 80 years old,with normal mental and neurological functions and nutritional functions.In the hyperlipidemia group,all the selected patients met the diagnostic criteria of acute pancreatitis,and serum triglyceride levels exceeded 11.30 mmol/L or 5.65-11.30 mmol/L.However,the blood samples in vitro were chyle-like,and other causes of pancreatitis should be excluded.Biliary origin group: All the selected patients accorded with acute pancreatitis.At the same time,CT,abdominal color Doppler ultrasound,MRI or MRCP showed biliary tract stones with or without abnormal glutamyl transaminase,glutamyl transpeptidase,bilirubin and other indicators.The patients with severe cardiopulmonary,liver and kidney dysfunction,mental disorders before admission,neurological diseases,motor dysfunction,language dysfunction,illiteracy,systemic immune system dysfunction,pregnancy and lactation were excluded.Comparison of nutritional function(transferrin,prealbumin and albumin),inflammatory cytokines(tumor necrosis factor-?,high-sensitivity C-reactive protein and interleukin-6),blood glucose index(fasting)Blood sugar,2h postprandial blood glucose,steady state model insulin resistance index);blood lipid related indicators(total cholesterol,triglyceride,high density lipoprotein cholesterol,low density lipoprotein cholesterol,apolipoprotein A and apolipoprotein B);Ranson score and APACHE II score,and risk factors for hyperlipidemia pancreatitis.Results: The duration of abdominal pain,blood amylase and urine amylase in hyperlipidemic pancreatitis group were longer than those in biliary pancreatitis group(p< 0.0001).The levels of transferrin,prealbumin and albumin in hyperlipidemic pancreatitis group were significantly lower than those in biliary pancreatitis group(p < 0.0001).The levels of inflammatory factors such as TNF-alpha,hypersensitive C-reactive protein and interleukin-6 in hyperlipidemic pancreatitis were significantly higher than those in biliary pancreatitis(p<0.0001,p=0.00054,p<0.0001);Among the indicators of glycometabolism in hyperlipidemic pancreatitis,fasting blood glucose and 2h postprandial blood glucose were higher than those in biliary pancreatitis group(p < 0.0001),insulin resistance was significantly higher than that in biliary pancreatitis group(p < 0.0001).Total cholesterol,triglyceride,low density lipoprotein and apolipoprotein B in hyperlipidemic pancreatitis group were higher than those in biliary pancreatitis group(p<0.0001,p<0.0001,p<0.0001,p=0.0066),while high density lipoprotein and apolipoprotein A were lower than those in biliary pancreatitis group(p < 0.0001);Ranson score and APACHE II score in hyperlipidemic pancreatitis group were higher than those in biliary pancreatitis group(p < 0.0001);the total hospitalization time in hyperlipidemic pancreatitis group was longer than that in biliary pancreatitis group(p=0.0049),and the total hospitalization time in ICU was longer than that in biliary pancreatitis group(p <0.0001);the total incidence of pancreatic infection,pancreatic pseudocyst and pancreatic abscess in hyperlipidemic pancreatitis group was significantly higher than that in biliary pancreatitis group(p < 0.0001).Male,over 60 years old,past malnutrition,hypertension,hyperlipidemia and diabetes mellitus were all risk factors of hyperlipidemic pancreatitis.Conclusion: Compared with biliary pancreatitis,the duration of abdominal pain,the duration of blood starch elevation and the duration of urinary starch elevation are longer in patients with hyperlipidemia pancreatitis,the blood lipid index is abnormal,and the nutritional status of the body is worse.The inflammatory reaction is more obvious,the blood sugar metabolism is significantly disordered,the total hospital stay and total intensive care unit time are significantly prolonged,and the possibility of complications is greater;male,older than 60 years old,malnourished,combined Hypertension,hyperlipidemia,and diabetes are all risk factors for the onset of hyperlipidemic pancreatitis.