• 糖尿病合并复发性急性胰腺炎的复发时间、糖脂变化及危险因素分析
  • Recurrent time, glycolipid changes and risk factors of diabetes mellitus complicated with recurrent acute pancreatitis
  • 杨宁梅.糖尿病合并复发性急性胰腺炎的复发时间、糖脂变化及危险因素分析[J].内科急危重症杂志,2021,27(1):19-22
    DOI:10.11768/nkjwzzzz20210106
    中文关键词:  急性胰腺炎  糖尿病  复发  糖脂代谢  危险因素
    英文关键词:
    基金项目:
    作者单位E-mail
    杨宁梅 四川省南充市中心医院 xiaoye664@163.com 
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    中文摘要:
          目的:观察糖尿病合并复发性急性胰腺炎(RAP)的复发时间、患者糖脂变化情况,并探讨其复发的危险因素。 方法: 回顾性分析166例初发的急性胰腺炎(AP)患者,根据其是否患有糖尿病分为糖尿病合并初发AP组(观察组)和非糖尿病合并初发AP组(对照组)。收集2组患者的一般情况、病因及AP的严重程度并随访,了解复发间隔时间及其危险因素。结果:①与对照组比较,观察组患者体重指数、AP严重程度及合并高脂血症和胆源性AP患者的构成比更高(均P<0.05);②2组复发率差异无统计学意义(P>0.05);观察组患者第1次复发距初发中位间隔时间短于对照组(χ2=5.31,P=0.02),在随访期内复发次数也高于对照组(P<0.05);③对照组患者复发后空腹血糖升高(P<0.05),有10例出现继发性糖尿病;观察组复发后空腹血糖及甘油三脂(TG)水平有显著升高(均P<0.05);④多因素logistic回归分析发现,吸烟史、BMI升高、胆源性因素和高脂血症是糖尿病合并初发AP患者复发的独立危险因素(均P<0.05)。结论: 糖尿病合并初发AP患者易复发,复发后糖脂代谢负荷加重;吸烟史、BMI、胆源性因素和高脂血症与糖尿病合并初发AP患者复发密切相关。
    英文摘要:
          Objective: To observe the recurrent time of diabetes mellitus complicated with recurrent acute pancreatitis (RAP), the changes of glucose and lipids in relapsed patients, and to explore the risk factors for recurrence of diabetes mellitus complicated with RAP. Methods: 166 patients with newly diagnosed acute pancreatitis (AP) admitted to our hospital from January 2016 to January 2018 were retrospectively analyzed. According to whether they had diabetes, they were divided into diabetes combined with newly diagnosed AP group (observation group) and non diabetes combined with newly diagnosed AP group (control group). The general situation, etiology and severity of AP of the two groups were collected, and all patients were followed up to understand the recurrence, recurrence frequency and risk factors. Results: ①The body mass index, the severity of AP and the constituent ratio of patients with hyperlipidemia and biliary AP in the observation group were significantly increased as compared with those in the control group (all P< 0.05); ②There was no significant difference in the recurrence rate between the two groups (P>0.05). The median interval time between the first recurrence and the first onset in the observation group was significantly shorter than that in the control group (χ2 = 5.31,P=0.02), and the recurrence frequency during the follow up period was also significantly greater than that in the control group; ③In the control group, fasting blood glucose increased after recurrence (P< 0.05), and 10 patients developed secondary diabetes; in the observation group, fasting blood glucose and TG levels increased significantly after recurrence (P <0.05); ④Multivariate logistic regression analysis showed that smoking history, increased body mass index, biliary factors and hyperlipidemia were independent risk factors for relapse in patients with newly diagnosed AP (P< 0.05). Conclusion: Patients with diabetes mellitus complicated with primary AP are more likely to relapse, and the load of glucose and lipid metabolism becomes heavier after relapse. Smoking history, body mass index, biliary factors and hyperlipidemia are closely related to the relapse of patients with diabetes mellitus complicated with primary AP.