对高脂血症性及胆源性急性胰腺炎患者C-反应蛋白和D-二聚体水平变化的观察

发布时间：2018-05-10 11:45

本文选题：高脂血症 + 急性病　；参考：《重庆医学》2017年01期

【摘要】：目的研究C-反应蛋白(CRP)和D-二聚体(D-dimer)在高脂血症性急性胰腺炎(HLAP)及胆源性急性胰腺炎(BAP)患者中的变化。方法选择2012年1月至2014年12月该院住院急性胰腺炎患者155例,根据病因分为HLAP组和BAP组。根据严重程度分为轻度急性胰腺炎(MAP)亚组和中度急性胰腺炎(MSAP)亚组。检测血常规、肝肾功能、血糖(Glu)、血钙(Ca2+)、总胆红素(TBIL)和直接胆红素(DBIL)、CRP和D-dimer。结果HLAP组的血小板(PLT)、Glu和血脂指标胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及三酰甘油(TG)均明显高于BAP组,而丙氨酸转氨酶(ALT)、γ-谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)、TBIL、DBIL、Ca2+和血肌酐(Cr)则明显低于BAP组(P0.05)。HLAP组的CRP明显高于BAP组并且差异有统计学意义(P0.01)。MAP、MSAP亚组中的HLAP组与BAP组相比较,CRP差异均有统计学意义(P0.01)。HLAP组MAP和MSAP亚组间的CRP和D-dimer差异均有统计学意义(P0.01),BAP组MAP和MSAP亚组间的CRP和D-dimer差异也均有统计学意义(P0.01)。HLAP组的CRP和D-dimer升高均是出现MSAP的危险因素(OR=1.121、3.716,P=0.025、0.001)。BAP组仅D-dimer升高是出现MSAP的危险因素(OR=2.717,P=0.002)。结论 CRP和D-dimer在HLAP及BAP中均随病情加重而升高,并且CRP升高在HLAP患者中更加明显。
[Abstract]:Objective to study the changes of C-reactive protein (CRP) and D-dimer in hyperlipidemic acute pancreatitis (HLAP) and biliary acute pancreatitis (BAP). Methods from January 2012 to December 2014, 155 patients with acute pancreatitis were divided into HLAP group and BAP group. According to severity, it was divided into mild acute pancreatitis (MAP) subgroup and moderate acute pancreatitis subgroup (MSAP) subgroup. Blood routine examination, liver and kidney function, blood glucose Glun, serum calcium, total bilirubin TBILs, direct bilirubin DBILP CRP and D-dimer were detected. Results compared with BAP group, HLAP group was significantly higher than that of BAP group in terms of platelet level, cholesterol index, low density lipoprotein cholesterol (LDL-C) and triglyceride triglyceride (TG). However, the CRP of alanine aminotransferase (alt), 纬 -glutamyl transpeptidase (GGT), alkaline phosphatase (ALP) TBILILN Ca 2 and serum creatinine (Cr) in BAP group was significantly higher than that in BAP group (P 0.01 .MAPMSAP subgroup) and BAP group. There were significant differences in CRP and D-dimer between MAP and MSAP subgroups. There was also significant difference in CRP and D-dimer between MAP and MSAP subgroups. The increase of CRP and D-dimer in HLAP group was the risk factor of MSAP. The increase of D-dimer is the risk factor of MSAP. Conclusion both CRP and D-dimer in HLAP and BAP are increased with the exacerbation of the disease, and the increase of CRP is more obvious in HLAP patients.
【作者单位】：首都医科大学附属北京朝阳医院消化内科;首都医科大学附属北京朝阳医院内分泌科;
【基金】：首都医科大学2015年度本科生科研创新项目(XSKY2015170)
【分类号】：R576;R589.2

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