脂肪胰与急性胰腺炎严重程度的临床研究

发布时间：2018-05-01 03:30

  本文选题：脂肪胰 + 急性胰腺炎　； 参考：《浙江大学》2017年硕士论文

【摘要】：背景与目的:随着肥胖与代谢综合征患者的增加,与其密切相关的脂肪胰也引起了研究者的注意。脂肪胰(Nonalcoholic fatty pancreas disease,NAFPD)是一种普遍但常常被临床医生忽视的疾病,已有研究表明它与代谢综合征、糖尿病、急慢性胰腺炎、胰腺癌等均密切相关。急性胰腺炎是常见的急腹症,重症胰腺炎常因并发器官衰竭而预后不佳。本研究的目的为探究脂肪胰与急性胰腺炎严重程度的关系。方法:选取于2014.1.1至2016.12.31期间至浙江大学附属第一医院急诊或住院的急性胰腺炎病人,并且在入院后48h内行腹部计算机断层扫描(CT)增强检查,发病前1年内行腹部CT检查。测量研究对象胰腺CT值、脾脏CT值、内脏脂肪组织(Visceral adipose tissue,VAT),计算其体重指数(Body mass index,BMI),评估其发病后Ranson's评分、APACHE Ⅱ(急性生理功能和慢性健康状况评分表Ⅱ)评分、MCTSI(修正CT严重指数)评分。比较胰腺CT值与脾脏CT值之差与之比(P-SP/S)、VAT、BMI与上述评分的关系。结果:入组30例患者中,男性占56.7%(17/30),女性占43.3%(13/30),平均年龄57.73±16.6岁。轻症胰腺炎患者占60%(18/30);重症胰腺炎患者占40%(12/30)。重症胰腺炎患者胰腺CT平均值、P-S、P/S显著低于轻症胰腺炎患者。并且胰腺CT平均值、P-S、P/S均与Ranson's评分、APACHEⅡ评分、MCTSI评分显著相关。脂肪胰组重症胰腺炎患者比率明显高于非脂肪胰组。重症胰腺炎患者内脏脂肪组织显著高于轻症胰腺炎患者,重症胰腺炎与轻症胰腺炎患者BMI无显著性差异。结论:脂肪胰与急性胰腺炎严重程度相关,并且P-S、P/S与急性胰腺炎严重程度成负相关。内脏脂肪组织与急性胰腺炎严重程度相关。脂肪胰及高内脏脂肪组织患者更易发展为重症胰腺炎,因此,两者在早期评估急性胰腺炎预后中均有重要作用。
[Abstract]:Background & objective: with the increase of obesity and metabolic syndrome, fatty pancreas, which is closely related to obesity and metabolic syndrome, has also attracted the attention of researchers. Nonalcoholic fatty pancreas disease (NAFPDD) is a common disease that is often neglected by clinicians. It has been shown to be closely related to metabolic syndrome, diabetes mellitus, acute and chronic pancreatitis, pancreatic cancer and so on. Acute pancreatitis is a common acute abdomen, severe pancreatitis is often associated with organ failure and poor prognosis. The aim of this study was to explore the relationship between fatty pancreas and severity of acute pancreatitis. Methods: patients with acute pancreatitis were selected from the first affiliated Hospital of Zhejiang University from January 1 to December 31, 2014.The patients were examined by CT within 48 hours after admission, and abdominal CT was performed within 1 year before the onset of the disease. The CT values of pancreas and spleen were measured. Visceral adipose tissue was collected from visceral adipose tissue of visceral adipose tissue. The body mass index (BMI) was calculated, and the Ranson's score and Apache 鈪，

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