中国血液净化

中国血液净化 ›› 2019, Vol. 18 ›› Issue (03): 173-176.doi: 10.3969/j.issn.1671-4091.2019.02.008

• 临床研究 • 上一篇    下一篇

血液透析合并急性胰腺炎患者临床特点分析

许慧莹1,李月红1   

  1. 1.北京清华长庚医院肾内科清华大学临床医学院
  • 收稿日期:2018-10-25 修回日期:2018-12-15 出版日期:2019-03-12 发布日期:2019-03-05
  • 通讯作者: 李月红 liyuehong0616@163.com E-mail:liyuehong0616@163.com

Clinical analysis of acute pancreatitis in maintenance hemodialysis patients

  • Received:2018-10-25 Revised:2018-12-15 Online:2019-03-12 Published:2019-03-05

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摘要： 【摘要】目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者并发急性胰腺炎的临床特点和病因机制。方法回顾性分析2017.07～2018.09 北京清华长庚医院125 例MHD 患者，分为胰腺炎组和对照组，总结2 组患者的临床表现、生化、影像检查特点及治疗预后。结果并发急性胰腺炎MHD患者共5 例(4%)，临床表现以腹痛、呕吐为主，与对照组相比，并发急性胰腺炎患者的血钙[(2.52±0.07)mmol/L 比(2.13±0.03)mmol/L，t=3.534,P＜0.001]、空腹血糖[(12.93±1.96)mmol/L 比(8.37±0.36)mmol/L，t=2.529,P =0.013]和血红蛋白水平[(123.80±7.77)g/L 比(113.26±1.15)g/L，t=2.197,P =0.028]均明显升高，差异具有统计学意义；2 组患者在年龄、Kt/V、血白蛋白、血肌酐、血磷、总胆固醇、三酰甘油、全段甲状旁腺激素、左室射血分数和平均超滤量方面差异均无统计学意义。结论血液透析患者发生急性胰腺炎的机制与血钙、血糖和血红蛋白等因素有关，连续性血液净化治疗有助于合并重型急性胰腺炎MHD 患者的治疗。

关键词: 血液透析, 急性胰腺炎, 血液净化, 血钙

Abstract: 【Abstract】Objective To explore the clinical features and possible etiology of acute pancreatitis in maintenance hemodialysis (MHD) patients. Method A total of 125 MHD patients in our dialysis center from July 2017 to September 2018 were enrolled in this study and divided into pancreatitis group and control group. The clinical manifestations and biochemical examination results of the patients in pancreatitis group were analyzed. Results Five MHD cases (4%) with acute pancreatitis are analyzed. The main clinical manifestations are abdominal pain and vomiting. As compared with the control group, patients in pancreatitis group have significantly higher levels of serum calcium (2.52±0.07mmol/L vs. 2.13±0.03mmol/L, t=3.534, P＜0.001), fasting blood glucose (12.93±1.96mmol/L vs. 8.37±0.36mmol/L, t=2.529, P=0.013) and hemoglobin (123.80±7.77g/L vs. 113.26±1.15g/L, t=2.197, P=0.028). There are no significant differences in age, kt/v, serum albumin, serum creatinine, serum phosphorus, serum cholesterol, serum triglycerides, serum parathyroid hormone, left ventricular ejection fraction and average between the two groups. Conclusion Higher levels of serum calcium, fasting blood glucose and hemoglobin may be responsible for the complication of acute pancreatitis in MHD patients. Continuous blood purification treatment is effective in severe acute pancreatitis.

Key words: Hemodialysis, Pancreatitis, blood purification, Calcium