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目的探讨非胆源性急性胰腺炎(AP)伴代谢综合征(MS)的临床特征。方法收集96例非胆源性AP患者的临床资料,其中伴MS的患者36例(MS组)、不伴MS的患者60例(非MS组),回顾性分析2组患者的临床资料,包括入院时的一般情况、Ranson评分、CRP、血钙、甘油三酯、血氧分压、合并症、局部及系统并发症、是否合并全身炎症反应综合征(SIRS)等。结果 MS组与非MS组比较,MS组年龄[(41.53±12.73)岁vs.(49.97±15.48)岁,P=0.007]、血钙[(2.01±0.21)mmol/L vs.(2.11±0.20)mmol/L,P=0.031]、血氧分压[(77.69±14.91)mm Hg vs.(85.89±20.78)mm Hg,P=0.041]低于非MS组;MS组的体质指数[(29.11±3.09)kg/m2 vs.(24.59±4.24)kg/m2,P<0.001]、合并脂肪肝的比例(83.3%vs.50.0%,P=0.001)、高甘油三酯血症患者比例(88.9%vs.36.7%,P<0.001)、Ranson评分[(2.44±1.44)分vs.(1.82±1.27)分,P=0.028]、血CRP[66.70(13.30,164.75)mg/L vs.35.25(6.49,77.28)mg/L,P=0.032]均高于非MS组;MS组的局部和系统并发症发生率(局部:27.8%vs.10.0%,P=0.045;系统:44.4%vs.21.7%,P=0.023)较非MS组高,差异均有统计学意义。结论非胆源性AP伴MS通常病情较重,并发症多。是否合并MS可作为评估AP病情严重程度及评价预后的因素之一。
Objective To investigate the clinical features of non-gallstone acute pancreatitis (AP) with metabolic syndrome (MS). Methods The clinical data of 96 patients with non-biliary AP were collected, including 36 patients with MS (MS group) and 60 patients without MS (non-MS group). The clinical data of 2 patients were retrospectively analyzed, including Ranson score, CRP, serum calcium, triglycerides, partial pressure of oxygen, complications, local and systemic complications, and systemic inflammatory response syndrome (SIRS). Results Compared with the non-MS group, the MS group had significantly higher age (41.53 ± 12.73 vs. 49.97 ± 15.48 years, P = 0.007), serum calcium (2.01 ± 0.21) mmol / L vs. (2.11 ± 0.20 ) mmol / L, P = 0.031], and partial pressure of blood oxygen [(77.69 ± 14.91) mm Hg vs. (85.89 ± 20.78) mm Hg, P = 0.041] (3.09) kg / m2 vs. (24.59 ± 4.24) kg / m2, P <0.001), the proportion of patients with fatty liver (83.3% vs.50.0%, P = 0.001), and the proportion of patients with hypertriglyceridemia (2.44 ± 1.44) vs (1.82 ± 1.27), P = 0.028], blood CRP [66.70 (13.30,164.75) mg / L vs.35.25 (P <0.001) 6.49, 77.28) mg / L, P = 0.032] were higher than those in the non-MS group. The incidence of local and systemic complications was significantly higher in the MS group (local: 27.8% vs. 10.0%, P = 0.045; %, P = 0.023) than non-MS group, the differences were statistically significant. Conclusion Non-gallstone AP with MS is usually more serious and has more complications. Whether or not MS is combined can be used as one of the factors to assess the severity of AP and assess the prognosis.