| 黄峰 付林 袁光雄 许俊 王启林.糖代谢异常与急性胰腺炎严重程度的相关性研究[J].,2014,14(25):4917-4920 |
| 糖代谢异常与急性胰腺炎严重程度的相关性研究 |
| Study on the Correlation of Severity of Acute Oancreatitis with AbnormalGlucose Metabolismand its Prognosis |
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| DOI： |
| 中文关键词: 急性病 胰腺炎 葡萄糖/ 代谢 胰岛素抗药性 预后 |
| 英文关键词: Acute disease Pancreatitis Glucose/metabolism Insulin resistance Prognosis |
| 基金项目:云南省教育厅科学研究基金项目（2012Z076） |
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| 中文摘要: |
| 目的：探讨急性胰腺炎(Acute pancreatitis，AP)严重程度与糖代谢异常的相关性及其预后。方法：选择2006 年7 月至2013 年
6 月我院消化科收治入院的急性胰腺炎患者158 例，按疾病严重程度分为轻症急性胰腺炎(MAP) 组68 例和重症急性胰腺炎
(SAP)组90 例；检测两组患者糖代谢指标空腹静脉血糖(FPG)、负荷2 h静脉血糖(PPG)及评定两组患者急性生理及慢性健康评分
Ⅱ (APACHEⅡ)，对两组的糖代谢指标和APACHE Ⅱ评分进行相关性分析，并观察两组患者的预后。结果：SAP组患者FPG、
PPG、胰岛素水平(FINS)、胰岛素抵抗指数(IRI)明显高于MAP 组，胰岛素敏感指数(ISI)低于MAP(P<0.01)；急性胰腺炎(AP)患者的
APACHE Ⅱ评分与FPG、PPG、FINS、IRI 呈正相关(P<0.05，P<0.01)，与ISI 呈负相关(P<0.05)；SAP 组的假性囊肿、感染、脓肿、坏
死、急性肺损伤或急性呼吸窘迫综合征(ARDS)、死亡发生率明显高于MAP 组(P<0.05，P<0.01)。结论：AP 的严重程度与糖代谢异
常存在密切的关系，两者相互影响,因此，在治疗AP 时,应积极控制胰腺炎症,防止和减少胰腺坏死，将血糖降至正常范围, 以降低
并发症和死亡的发生率。 |
| 英文摘要: |
| Objective:To investigate correlation between severity of acute pancreatitis and the abnormal glucose metabolism and
its prognosis.Methods:A total of 158 cases of patientwith acute pancreatitis admitted in our hospital from July 2006 to June 2013 were
selected, and were divided into two groups: mild acute pancreatitis (MAP; n=68) and severe acute pancreatitis (SAP; n=90) according to
the disease severity. The patient's sugar metabolismsuch as fasting plasma glucose (FPG), postprandial plasma glucose (PPG) and acute
physiology and chronic health evaluation Ⅱ(APACHEII) scores of the two groups were detected. Correlation analysis was carried out between
glucose metabolism index and APACHEII score. The prognosis of the two groups was observed.Results:The FPG, PPG, fasting
insulin levels (FINS), and insulin resistance index (IRI) levels of SAP group were significantly higher than those of the MAP group. The
insulin sensitivity index (ISI) level was lower than that of MAP group (P<0.01). APACHE Ⅱ score of acute pancreatitis (AP) patient was
positively correlated with FPG, PPG, FINS, and IRI (P<0.05, P<0.01), and was negatively correlated with ISI (P<0.05). The incidence of
pseudocyst (infection, abscess, and necrosis), acute lung injury or acute respiratory distress syndrome (ARDS), and death in SAP group
was significantly higher than that in MAP group (P< 0.05, P< 0.01).Conclusion:There was a close relationship between AP severity and
abnormal glucose metabolism. Therefore, in treating AP, acute pancreatitis should be actively controlled to prevent and reduce pancreatic
necrosis, and the blood glucose should be decreased to the normal range to reduce morbidity and mortality. |
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