Analysis Of Clinical Features And Risk Factors Of Recurrent Acute Pancreatitis

Objective:To analyze the clinical characteristics of patients with recurrent pancreatitis and to explore the risk factors of recurrence of acute pancreatitis,so as to provide reference for the future clinical diagnosis and treatment of RAP.Methods:Clinical data of patients with newly diagnosed acute pancreatitis(AP)who visited the general hospital of General hospital of NingXia Medical university from January2015 to December 2017 were collected and followed up to October 2018.According to the follow-up results,the patients were divided into single group and recurrent group according to the diagnostic criteria of RAP,we detailed clinical data of the two groups of patients who visited the hospital for the first time were collected for analysis and comparison.The clinical characteristics of RAP in the regional recurrence group were preliminarily understood,and the associated risk factors of AP recurrence were analyzed by Logistic regression.Results1 : 1.A total of 1035 patients with AP had 126 cases of recurrence,with a recurrence rate of 12.17%.2.Comparison of general data: the relapse group included 77 young patients(61.1%),23middle-aged patients(18.3%)and 26 elderly patients(20.6%).Single incidence group: 382 young patients(42%),243 middle-aged patients(26.8%),284 elderly patients(31.3%);Compared with the relapse group,the proportion of young patients was higher in the two groups,and the proportion of middle-aged and elderly patients was higher in the single group,and the difference was statistically significant(P<0.05).There was no significant difference in gender between the two groups(P>0.05).3.Etiological comparison: in the relapse group,57 cases(45.2%)were hyperlipidemia,44 cases(34.9%)were biliary,14 cases(11.1%)were idiopathic,8 cases(6.3%)were alcoholic,and 3 cases(2.4%)were other known etiology.Single incidence group: 481 cases(53.0%)of bile,151 cases(16.6%)of hyperlipidemia,220 cases(24.2%)of idiopathic,46cases(5.0%)of alcohol,11 cases(1.2%)of other known causes.The incidence of biliary factors,idiopathic factors and other causes in the single group was higher than that in the recurrence group,and the incidence of hyperlipidemia and alcoholic factors in the recurrence group was higher than that in the single group,with statistically significant differences(P<0.05).4.Comparison of clinical characteristics:(1)smoking patients: 50 cases(39.68%)in the relapse group and 256 cases(28.25%)in the single incidence group;(2)patients with alcohol consumption: there were 42 cases(33.3%)in the relapse group and 204 cases(22.5%)in the single group.(3)patients with diabetes mellitus: there were 33 cases(26.2%)in the relapse group,and 103 cases(11.25%)in the single disease group.(4)combined pancreatic bad death:recurrence group of 15 cases(11.9%),and single group of 33 cases(3.5%);(5)complications:28 cases(22.2%)in the recurrence group,132 cases(14.5%)in the single incidence group;(6)severe patients: recurrence group of 38 cases(30.2%),the single group of 160 cases(26.4%).After statistical analysis,there were statistically significant differences between the two groups in smoking,drinking,diabetes mellitus,pancreatic necrosis,and complications.After multivariate regression analysis: pancreatic necrosis,hyperlipidemia,diabetes mellitus,smoking,and drinking were risk factors for AP recurrence.5.In the recurrence group: cholecystectomy was performed in 7 cases(16.3%)and no cholecystectomy was performed in 36 cases(83.7%).Single group: cholecystectomy: 197cases(41.4%)and 279 cases(58.8%)without cholecystectomyConclusion:1.The main causes of RAP are hyperlipidemia,gallbladder,and idiopathic successively.Hyperlipidemia is an independent risk factor for AP recurrence,and the combination of diabetes,pancreatic necrosis,smoking,and drinking can increase the risk of RAP recurrence.2.Aggressive treatment of the etiology after the first attack in patients with biliary AP can reduce the recurrence rate...