Analysis Of Clinical Features And Risk Factors Of Recurrent Acute Pancreatitis

ObjectivesTo analyze the risk factors and clinical characteristics of recurrent acute pancreatitis(RAP),so as to Precision treatment of etiology,improve the efficacy of RAP with accurate treatment.MethodsA retrospective analysis was conducted to collect 519 patients with acute pancreatitis who were hospitalized from January 2013 to December 2018 in The Second Affiliated Hospital of Shandong First Medical University.The patients were divided into firstepisode group and recurrence group.The data of hospitalization number,sex,age,laboratory examination and imaging findings were collected.Recording and treatment were carried out.The recurrence group was compared with 432 patients with first attack of pancreatitis at the same time.87 patients with recurrence were analyzed within the group to find out the risk factors of recurrence.ResultsThe incidence of recurrent acute pancreatitis(RAP)was 16.7%(87/519),the recurrence times were 1-7,the average attack times were 1.49 times per case,the average age of onset was 48.3±15 years old,and male was the predominant.The average age of onset in the first group was 52.8±18 years old,and there was significant difference between the two groups(P<0.05).The recurrence interval of recurrent acute pancreatitis was mostly in patients with one recurrence(66.7%).The average hospitalization days(11.57days)in the recurrence group were not significantly different from those in the first group(11.3days)(P>0.05).The risk of complications(34.5%)in the recurrence group was higher than that in the first group(21.8%)(P<0.05),but the recurrence times were not related to the severity of the disease(P>0.05),and the severity of the disease was severe.The main cause of the disease was biliary origin.Etiology: The common causes of recurrence group and first-episode group were biliary,followed by RAP: hyperlipidemia(high triglyceride,high cholesterol),accounting for 27.6%(24/87),alcoholic 10.3%(9/87),idiopathic 8.0%(7/87),the first-episode group was 53.4%(231/432),alcoholic 16.0%(69/432),hyperlipidemia12.7%(55/432),idiopathic.Sex was 7.6%(33/432).There were no significant differences in the etiology of hyperlipidemia and alcoholism between the first group and the relapse group(P>0.05).In the laboratory examination,there were no significant differences in WBC,neutrophil/lymphocyte ratio,PT,total bilirubin,in blood sugar,blood calcium and blood amylase and CRP between the two groups(P>0.05),but significant differences in triglyceride(P<0.05).The mean triglyceride in the relapse group was 4.33±6.59 mmol/L,and in the first group was 1.92±3.12 mmol/L.Fruit regression analysis showed that triglyceride level was a risk factor for RAP(OR=0.909,95% CI:0.936-0.989;P<0.05).ConclusionRecurrent acute pancreatitis is predominant in middle-aged men.The main cause of RAP is biliary origin.It recurs more than one year later.Hyperlipidemia is an independent risk factor for recurrent acute pancreatitis.