非酒精性脂肪性肝病对急性胰腺炎严重程度的影响

发布时间：2018-03-01 01:24

本文关键词： 急性胰腺炎非酒精性脂肪性肝病严重程度回顾性分析危险因素　出处：《西安医学院》2017年硕士论文　论文类型：学位论文

【摘要】：目的通过对急性胰腺炎患者的资料进行回顾性分析,评估非酒精性脂肪性肝病与急性胰腺炎严重程度之间的关系,为急性胰腺炎的诊断、治疗、预防及预后研究提供科学依据。方法收集2013年6月-2016年9月在西安医学院第一附属医院诊断为急性胰腺炎的637例住院患者资料,根据诊断及排除标准最终纳入251例,其中男性144例(57.4%),女性107例(42.6%),年龄14-88岁,平均(45.37±15.46)岁。应用SPSS22.0软件对所有数据进行整理分析。两样本间的计量资料比较应用Mann-Whitney U检验(非正态分布)或t检验(正态分布),计数资料的两样本间比较应用χ2检验,多样本间的比较采用非参数检验中的二个独立样本检验;危险因素分析采用logistic回归分析,P0.05为有统计学意义。图表应用Excel2003及GraphPad Prism 6.0软件制作。结果1.合并非酒精性脂肪性肝病的患者,其急性胰腺炎的严重程度与不合并非酒精性脂肪性肝病的急性胰腺炎患者有差异,差异有统计学意义(χ2=11.004,P=0.001),非酒精性脂肪性肝病的严重程度对急性胰腺炎的严重程度有影响,差异有统计学意义(χ2=7.444,P=0.024)。非酒精性脂肪性肝病(95%CI:1.261-2.878,OR=2.478,P=0.017)、白细胞计数(95%CI:1.747-7.043,OR=3.508,P=0.000)、淀粉酶水平(95%CI:1.148-3.868,OR=2.107,P=0.016)与急性胰腺炎严重程度间存在相关性(似然比检验卡方=34.696,P0.001,模型有统计学意义)。2.体重指数和急性胰腺炎的严重程度间有差异,差异有统计学意义(χ2=13.082,P=0.004)。伴有肥胖的患者,其急性胰腺炎的严重程度与不伴有肥胖的急性胰腺炎患者间有统计学差异(χ2=9.092,P=0.003)。3.合并有非酒精性脂肪性肝病的急性胰腺炎患者,体重指数和甘油三酯有正相关性(r=0.360,P=0.000),体重指数与空腹血糖、甘油三酯与空腹血糖间均无相关性(P0.05)。结论1.非酒精性脂肪性肝病与急性胰腺炎的严重程度相关;且非酒精性脂肪性肝病的严重程度对急性胰腺炎的严重程度有影响;2.非酒精性脂肪性肝病、白细胞计数、血淀粉酶水平是影响急性胰腺炎严重程度的危险因素;3.体重指数是反映急性胰腺炎严重程度的指标。
[Abstract]:Objective to evaluate the relationship between non-alcoholic fatty liver disease and the severity of acute pancreatitis by retrospective analysis of the data of patients with acute pancreatitis, and to evaluate the diagnosis and treatment of acute pancreatitis. Methods from June 2013 to September 2016, 637 cases of acute pancreatitis diagnosed in the first affiliated Hospital of Xi'an Medical College were collected, and 251 cases were included according to the criteria of diagnosis and exclusion. Among them, 144 males (57.4%) and 107 females (42.6%), aged 14-88, The average age was 45.37 卤15.46 years old. All the data were analyzed by SPSS22.0 software. The comparison between the two samples was made by Mann-Whitney U test (non-normal distribution) or t test (normal distribution), and 蠂 2 test was used to compare the two samples of counting data. Two independent samples of non-parametric test were used to compare the multi-samples. The risk factors were analyzed by logistic regression analysis (P0.05). The chart was made with Excel2003 and GraphPad Prism 6.0 software. Results 1. The patients with non-alcoholic fatty liver disease, The severity of acute pancreatitis was significantly different from that of non-alcoholic fatty liver disease (蠂 ~ 2, 11.004, P < 0.001). The severity of non-alcoholic fatty liver disease had an effect on the severity of acute pancreatitis. The difference was statistically significant (蠂 2 / 7.444 / P 0.024). There was a correlation between 95CI: 1.261-2.878 / P 0.017, a white blood cell count of 95CIW 1.747-7.043OR3.508P0.000, amylase level 95CI1.148-3.868 / 107P0.016) and the severity of acute pancreatitis (the likelihood ratio was 34.696P _ 1), the model had statistical significance. There are differences in the severity of acute pancreatitis, The severity of acute pancreatitis in patients with obesity was significantly different from that in patients without obesity (蠂 2 9.092 P 0.003. 3). Patients with acute pancreatitis with non-alcoholic fatty liver disease were found to have a significant difference in the severity of acute pancreatitis (蠂 29.092P 0.003. 3), and there was a significant difference in the severity of acute pancreatitis between the patients with obesity and those without obesity (蠂 29.092P 0.003. 3). There was a positive correlation between BMI and triglyceride. There was no correlation between BMI and fasting blood glucose, triglyceride and fasting blood glucose. Conclusion 1. Non-alcoholic fatty liver disease is related to the severity of acute pancreatitis. The severity of non-alcoholic fatty liver disease has an effect on the severity of acute pancreatitis 2.The white blood cell count of non-alcoholic fatty liver disease, Serum amylase level is a risk factor affecting the severity of acute pancreatitis. Body mass index (BMI) is an index to reflect the severity of acute pancreatitis.
【学位授予单位】：西安医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R575;R576

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