| Purpose:AP is an inflammatory condition of the pancreas that can caused by various etiologies,and pancreatitis caused by different etiologies has its own characteristics.ABP and HTGP are the most common causes.This study intends to compare the clinical outcomes of AP from different aspects,so as to provide a basis for further understanding of pancreatitis.Methods:The clinical data of 178 AP patients in the First Affiliated Hospital of Nanchang University from January 1,2016 to December 31,2018 were analyzed retrospectively.from general data such as sex,age,BMI,laboratory index such as WBC,NEU,HCT,ALT,AST,TBil,DBil,TG,TC,BUN,Ca2~+,D-dimer,CRP and PCT,disease severity index such as the proportion of AP severity,SIRS response rate,organ failure rate,incidence of pacreatic local complications,mortality rate,occupation of medical resources index such as hospitalization costs,hospitalization time,housing days in ICU,Follow up index such as follow-up 1 year recurrence rate and the minimally invasive or surgical intervention rate of local complications of pancreas,all of these indexes were used to analyze the clinical outcomes in different aspects and angles by statistical methods.Results:1.By retrieve the case collection system of the First Affiliated Hospital of Nanchang University,the large database of pancreas group of digestive department and manually screening inpatients from January 1,2016 to December 31,2018,A total of 3132 AP inpatients were admitted.2555 of whom had not been diagnosed as ABP or HTGP and whom was attacked by AP more than 1 day were excluded,remaining 577 cases were included.77 patients over 70 or under 18 years old were excluded,remaining 500 cases were included,152 cases with pregnancy or lactation or repeated hospitalization due to AP recurrence within 3 years were excluded,the remaining 348 cases were included,96 cases with incomplete data were excluded,the remaining 252 cases were included,and 74 cases with lost visits were excluded.Finally,178 cases of AP met the inclusion criteria,including 63 cases in ABP group and 115 cases in HTGP group.2.There were 36 males and 27 females in ABP group,74 males and 41 females in HTGP group met the included criteria,There was no significant difference in gender between the two groups(P>0.05),the average age of ABP group was(54.68±11.69)years old,which was higher than that of HTGP group(39.60±9.81)years old,the difference was statistically significant(P<0.001).The BMI of HTGP group was(26.04±3.99)kg/m~2,which was higher than that of ABP group(24.20±2.26)kg/m~2,the difference was statistically significant(P<0.05).3.The level of ALT,AST,TBil and DBil in ABP group was higher than that in HTGP group,the level of TG and TC in HTGP group was higher than that in ABP group,the difference was statistically significant(P<0.001),the level of HCT and CRP in HTGP group was higher than that in ABP group,the difference was statistically significant(P<0.001),the level of Ca2~+in HTGP group was lower than that in ABP group,the difference was statistically significant(P<0.001).To further compare the levels of HCT,Ca2~+,CRP in serum of HTGP patients with different severity,The results showed that there was no significant difference in HCT between MAP,MSAP and SAP groups(P>0.05).The serum Ca2~+level of SAP group was lower than that of MAP and MSAP group(P<0.05),The serum Ca2~+level of MSAP group was no significant difference with MAP(P>0.05).The level of CRP in MSAP group was higher than that in MAP group(P<0.05),but there was no significant difference between SAP group and MSAP group(P>0.05).4.MAP accounted for 41.2%,MSAP for 31.7%,SAP for 27.0%in ABP group,MAP for 30.4%,MSAP for 51.3%,SAP for 18.3%in HTGP group,there was a significant difference in the severity of AP between the two groups(P<0.05).Further compared the severity of AP between ABP group and HTGP group,the results showed that HTGP group was more likely to develop MSAP than ABP group,and the difference was statistically significant(P<0.05),there was no statistically significant difference between the two groups in the incidence of MAP and SAP(P>0.05).The SIRS in HTGP group was 48.7%,and that in ABP group was 25.4%,The SIRS in HTGP group was easier than that in ABP group,The difference was statistically significant(P<0.05).The incidence of respiratory failure,circulatory failure,renal failure,MODS and POF in ABP group were 38.1%,9.5%,4.8%,11.1%and 17.5%respectively,The incidence of respiratory failure,circulatory failure,renal failure,MODS and POF in HTGP group were 28.7%,3.5%,4.3%,4.3%and 13.0%respectively,there was no significant difference in the incidence of respiratory failure,circulatory failure,renal failure,MODS and POF between the two groups,The difference was statistically significant(P<0.05).The incidence of local pancreatic complications was 66.1%in HTGP group and 49.2%in ABP group,HTGP was more likely to have local complications of pancreas than ABP,The difference was statistically significant(P<0.05).The mortality of ABP group was 6.3%,HTGP group was 1.7%,there was no significant difference between the two groups(P>0.05).5.The median costs of hospitalization in ABP group was 28241 yuan,the interquartile range was 14230-46282 yuan,the median costs of hospitalization in HTGP group was 16822 yuan,the interquartile range was 9116-32896 yuan,the difference was statistically significant(P<0.05).The median time of hospitalization in ABP group was 8 days,the interquartile range was 6-14 days,the median time of hospitalization in HTGP group was 8 days,the interquartile range was 5-14 days,there was no significant difference between the two groups(P>0.05).The median housing days in ICU in ABP group was 0 day,the interquartile range was 0-3 day,the median housing days in ICU in HTGP group was 0 day,the interquartile range was 0-4 day,the difference was not significant(P>0.05).6.The recurrence rate was 11.1%in ABP group and 21.7%in HTGP group after one year follow-up,there was no significant difference between the two groups(P>0.05).The minimally invasive or surgical intervention rate was 4.7%in ABP group and 2.6%in HTGP group after one year follow-up,there was no significant difference between the two groups(P>0.05).Conclusion:HTGP is more likely to occur in young and obese patients.The serum HCT and CRP level of HTGP is significantly higher than that of ABP.The serum Ca2~+level is lower than that of ABP.HTGP is more likely to develop into MSAP,SIRS reaction and local complications of pancreas.The hospitalization costs of the ABP group is higher than that of the HTGP group.There was no significant difference in the incidence of organ failure,mortality,recurrence rate,intervention rate,hospitalization time and housing days in ICU between the two groups. |
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