急性胰腺炎合并肝损伤临床分析.docVIP

急性胰腺炎合并肝损伤临床分析 　　[摘要] 目的 研究急性胰腺炎（AP）合并肝损伤的临床特征及对预后的影响。 方法 对187例急性胰腺炎患者的临床资料进行分析和比较，了解肝损伤的发生率以及肝损伤的程度对病情产生的影响。 结果 187例急性胰腺炎患者中合并肝损伤者112例，其中重症急性胰腺炎（SAP）65例，轻症急性胰腺炎（MAP）47例；胆源性急性胰腺炎（BAP）79例，非胆源性急性胰腺炎（NBAP）33例。SAP较MAP肝损伤发生率高（分别为100%和38.5%）；BAP比NBAP肝损伤发生率高（分别为74.5%和40.7%）。SAP患者肝脏功能受到的损伤程度较MAP更为严重，差异有统计学意义（P0.01）。SAP合并肝损伤患者较MAP合并肝损伤患者在腹痛缓解、血淀粉酶复常及肝功能恢复正常的时间方面均明显延长（P0.01）。 结论 急性胰腺炎合并肝损伤发生率高，其肝损伤程度与急性胰腺炎病情严重程度有关，掌握肝损伤的临床特点对临床治疗具有重要意义。 　　[关键词] 急性胰腺炎；肝损伤；肝功能；预后 　　[中图分类号] R576；R575 [文献标识码] B [文章编号] 1673-9701（2015）34-0037-03 　　Clinical analysis of acute pancreatitis with liver injury 　　LI Hongyu 　　Department of Gastroenterology， the Second Hospital of Fushun City in Liaoning Province，Fushun 113001，China 　　[Abstract] Objective To study the clinical features of acute pancreatitis（AP） with liver injury and its impact on prognosis. Methods 187 cases of patients with acute pancreatitis were analyzed and compared，to understand the incidence of liver injury and the influence of the degree of liver injury. Results In the 187 cases of AP patients， 112 cases were with liver injury， including 65 severe acute pancreatitis （SAP） and 47 cases of mild acute pancreatitis （MAP）. In the 79 cases of biliary acute pancreatitis（BAP） and 33 cases of non-biliary acute pancreatitis （NBAP）. The incidence of liver injury in the SAP group （100%） was higher than that in the MAP group （38.5%）； and the incidence of liver injury in the BAP group （74.5%） was higher than the NBAP group （40.7%）. From the statistical data，the degree of liver injury in the SAP group was severer than that in the MAP group，which was significant different（P0.01）. The abdominal pain relief time， time to normalization of serum amylase and liver function returned to normal were longer in SAP patients complicated with liver injury than those in the MAP patients complicated with liver injury（P0.01）. Conclusion AP complicated with liver injury has a high incidence rate. The degree of liver injury is associated with severity of AP.