中国血液净化

中国血液净化 ›› 2017, Vol. 16 ›› Issue (09): 587-591.doi: 10.3969/j.issn.1671-4091.2017.09.003

• 临床研究 • 上一篇    下一篇

血液灌流治疗急性高脂血症性胰腺炎的疗效分析

王菊香1,陈秋燕1,林小明1,陈辉民1   

  1. 1 厦门市第三医院重症医学科
  • 收稿日期:2017-04-11 修回日期:2017-07-18 出版日期:2017-09-12 发布日期:2017-09-12
  • 通讯作者: 陈辉民 102300xm@163.com E-mail:xuyimei@jafron.com
  • 基金资助:

    厦门市卫生和计划生育委员会资助研究经费，福建省医学创新课题《超声指导感染性休克患者循环管理的研究》项目编号：2015-CXB-48

Therapeutic effects of hemoperfusion on hypertriglyceridemia- induced acute pancreatitis

  • Received:2017-04-11 Revised:2017-07-18 Online:2017-09-12 Published:2017-09-12

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摘要： 目的探讨血液灌流(haemoperfusion，HP)对高血脂的清除作用及对急性高脂血症性胰腺炎(hypertriglyceridemia-induced acute pancreatitis,HTG-AP)的治疗作用。方法回顾性分析了HP 治疗HTG-AP 患者12 例，在常规治疗的基础上给予HP 治疗。分析血脂下降水平、临床表现、局部和全身并发症发生情况，住院天数和住院死亡率。结果12 例HTG-AP 患者，入院时三酰甘油(triglyceride, TG)水平为(54.542 ± 19.019)mmol/L、血浆胆固醇(cholesterol, CHOL)水平为(13.158 ± 5.242)mmol/L，第1 次HP 后TG 下降至(12.957 ± 9.934)mmol/L，下降率(77.740 ±11.668)%，t=6.714,P＜0.001；CHOL 下降至(8.294±6.960)mmol/L，下降率(36.482± 12.783)%，t =2.605，P=0.016。有5 例患者在次日接受第2 次HP 治疗使得TG 下降至10mmol/L 以下。在1～3 天内，所有患者的TG 水平在5.65mmol/L 以下。重症医学科(Intensive care unit, ICU)治疗(2.917±1.730)d，住院日(11.500±8.939)d。住院死亡率为0。结论HP 能够有效地降低HTG-AP 患者的血脂水平，改善患者的临床结局。

关键词: 血液灌流, 急性高脂血症性胰腺炎,  三酯甘油, 疗效

Abstract: Objective To evaluate the effects of hemoperfusion (HP) for the treatment of hyperlipidemia and hypertriglyceridemia- induced acute pancreatitis (HTG- AP). Methods Twelve patients suffering from HTG-AP were retrospectively analyzed. They were treated with HP in addition to routine treatment. The improvement of hyperlipidemia, clinical symptoms, local and systemic complications, hospitalization days and mortality rate were analyzed. Results In the 12 patients at the time of admission, serum triglyceride (TG) was 54.542±19.019 mmol/L, and serum cholesterol (CHOL) was 13.158±5.242 mmol/L. After the first session of HP, serum TG reduced to 12.957±9.934 mmol/L (reduction rate of 77.740±11.668%, P＜0.001) and serum CHOL reduced to 8.294±6.960 mmol/L (reduction rate of 36.482±12.783%, P=0.016). Five of the 12 patients reached a TG level <10 mmol/L after two sessions of HP, and all of the patients had the serum TG level < 5.65 mmol/L within 1-3 days. The duration in ICU was 2.917±1.730 days, and hospitalization period was 11.500±8.939 days. None of them died. Conclusion HP can effectively reduce serum TG level and improve clinical outcomes in HTG-AP patients.

Key words: Hemoperfusion, Hypertriglyceridemia-induced acute pancreatitis, Serum triglyceride concentration, Therapeutic effect