Risk Factors of Acute Pancreatitis Associated with Hepatic Dysfunction_West China Medical Journal

Authors：

 FuDan

Department of Gastroenterology, the Six People's Hospital of Chengdu, Chengdu, Sichuan 610051, P. R. China;

Corresponding?author：

Keywords：

Acute pancreatitis; Hepatic dysfunction; Risk factors

DOI：

10.7507/1002-0179.201600365

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Objective To analyze the risk factors of acute pancreatitis (AP) associated with hepatic dysfunction. Methods We collected the clinical data of AP patients from June 2012 to December 2014. According to the hepatic function, patients were divided into normal or mildly abnormal group (A), moderately abnormal hepatic function group (group B) and hepatic failure group (group C). We comparatively analyzed the relationship of abnormal hepatic function with causes (biliary, alcoholic, hypertriglyceridemia, and the others), age, gender, abdominal CT findings, laboratory test results, Ranson scores and the severity of acute pancreatitis bedside index (BISAP). Results A total of 117 AP patients were included in the study, including 75 males and 42 females aged from 28 to 71 years with the mean age of (53.21±1.35) years. There were 73 patients with mild AP (MAP), 28 with moderately severe AP (MSAP) and 16 with severe AP (SAP). There were 64 patients in group A, 37 in group B, and 16 in group C, in whom 73 patients were with hepatic dysfunction. The ratio of SAP and MSAP in group C was 75.0%, and MAP was 25.0%. There were 52 patients with bilious AP, 39 with alcoholic AP, 19 with hypertriacylglycerolemia AP, and 7 with others; the difference in causes among the three groups were not significant (P > 0.05). The differences in serum amylase, prothrombin time, white blood cells count, serum creatinine, triglycerides, total cholesterol, hemoglobin, and blood urea nitrogen among the three groups were not significant (P > 0.05). Conclusions AP associated with hepatic dysfunction or failure may be caused by a various of factors. Whether the changes of serum amylase, prothrombin time, white blood cell count, serum creatinine, triglycerides, total cholesterol, hemoglobin, blood urea nitrogen, and BISAP scores can be the indexes of the judgment of AP with hepatic dysfunction needs more researches. Proper assessment of the related risk factors helps to prevent serious hepatic dysfunction or even failure.

Citation： FuDan. Risk Factors of Acute Pancreatitis Associated with Hepatic Dysfunction. West China Medical Journal, 2016, 31(8): 1329-1333. doi: 10.7507/1002-0179.201600365 Copy

1.	陳紅艷, 劉明新, 胡群帆, 等.急性胰腺炎患者的肝功能檢測結果分析[J].國際檢驗醫學雜志, 2010, 31(3):301.
2.	王興鵬, 李兆申, 袁耀宗.中國急性胰腺炎診治指南(2013, 上海)[J].中華胰腺病雜志, 2013, 33(4):73-78.
3.	中華醫學會感染病學分會肝衰竭與人工肝學組, 中華醫學會肝病學分會重型肝病與人工肝學組.肝衰竭診治指南(2012年版)[J].中華肝臟病雜志, 2013, 21(3):177-183.
4.	Ranson JH. Etiological and prognostic factors in human acute pancreatitis:a review[J]. Am J Gastroenterol, 1982, 77(9):633-638.
5.	Singh VK, Wu BU, Bollen TL, et al. A prospective evaluation of the bedside index for severity in acute pancreatitis score in assessing mortality and intermediate markers of severity in acute pancreatitis[J]. Am J Gastroenterol, 2009, 104(4):966-971.
6.	周圓圓, 楊麗, 廖忠莉, 等. BISAP與Ranson's評分對急性胰腺炎患者預后評估的比較[J].第三軍醫大學學報, 2012, 34(7):658-661.
7.	Banks PA, Bollen TL, Ervenis C, et al. Classification of acute pancreatitis (2012):revision of the Atlanta classification and definitions by international consensus[J]. Gut, 2013, 62(1):102-111.
8.	張曉華, 李兆申, 許國銘, 等.急性胰腺炎肝臟損傷的表現及其發病機制的研究進展[J].第二軍醫大學學報, 2003, 24(10):1143-1145.
9.	王洪亮, 吳傳新.重癥急性胰腺炎時HMGB1與肝損害的關系[J].國際檢驗醫學雜志, 2011, 32(2):210-211.
10.	He ZJ, Matikainen MP, Alho H, et al. Extrapancreatic organ impairment in caerulein induced pancreatitis[J]. Ann Chir Gynaecol, 1999, 88(2):112-117.
11.	李海燕, 陳瑞芬, 王民, 等.急性胰腺炎時胰、肺和肝微循環的形態觀察[J].電子顯微學報, 2004, 23(4):301-302.
12.	Halonen KI, Pettila V, Leppaniemi AK, et al. Multiple organ dysfunction associated with severe acute pancreatitis[J]. Crit Care Med, 2002, 30(6):1274-1279.
13.	任文濤, 姜文弟, 張東海.急性胰腺炎并發肝損害的臨床分析[J].胰腺病學, 2005(1):43-44.
14.	高琦.重癥急性胰腺炎患者肝功能衰竭的相關危險因素分析[J].現代預防醫學, 2013, 40(19):3705-3707.
15.	熊琪山.急性胰腺炎合并肝損害50例臨床分析[J].華西醫學, 2004, 19(4):605.
16.	趙玲.急性胰腺炎合并肝損害32例臨床分析[J].中華腹部疾病雜志, 2005, 5(3):172-173.
17.	王孚軒.急性胰腺炎合并肝損害91例臨床分析[J].臨床醫學, 2009, 29:56-57.
18.	屈健寧, 蔡大川.急性胰腺炎合并肝損害152例臨床分析[J].重慶醫學, 2010, 39(5):549-550.
19.	徐路, 王青, 唐欣.急性胰腺炎合并肝損害32例臨床分析[J].重慶醫學, 2009, 38(1):120-121.
20.	龍慶林, 房殿春. 90例急性胰腺炎胰外損害臨床分析[J].重慶醫學, 2003, 32(1):63-64.
21.	黃漢明, 嚴友德.急性胰腺炎伴肝損害155例臨床研究[J].南京醫科大學學報:自然科學版, 2001, 21(4):371-372.
22.	李和平, 張秀琳.急性胰腺炎合并肝損害36例臨床分析[J].陜西醫學雜志, 2008, 37(7):848-849.
23.	吳康為, 吳金明, 林春景, 等.急性胰腺炎合并肝損害的臨床分析[J].溫州醫學院學報, 2008, 38(4):368-370.
24.	王艷平.急性胰腺炎肝功能損害81例分析[J].醫學理論與實踐, 2011, 24(22):2699-2700.
25.	陳佩.急性胰腺炎并肝損傷90例診治體會[J].山東醫藥, 2009, 49(22):70.
26.	Wu BU, Johannes RS, Sun X, et al. The early prediction of mortality in acute pancreatitis:a large population-based study[J]. Gut, 2008, 57:1698-1703.
27.	Papachristou GI, Muddana V, Yadav D, et al. Comparison of BISAP, Ranson's, APACHE-Ⅱ, and CTSI scores in predicting organ failure, complications, and mortality in acute pancreatitis[J]. Gastroenterology, 2010, 105(2):435-441.
28.	胡瑞瑞, 張琪, 田字彬. BISAP評分系統對重癥急性胰腺炎的評估價值[J].中華胰腺病雜志, 2011, 11(4):231-233.
29.	郭小燕, 萬榮, 徐萍, 等. BISAP評分對急性胰腺炎患者病情嚴重度及預后評估價值的研究[J].胃腸與肝臟病學雜志, 2012, 21(12):1097-1104.
30.	張偉, 單宏超, 郭善禹.急性胰腺炎病人急性肝功能損害[J].中華肝膽外科雜志, 2004, 10(4):225-227.

1. 陳紅艷, 劉明新, 胡群帆, 等.急性胰腺炎患者的肝功能檢測結果分析[J].國際檢驗醫學雜志, 2010, 31(3):301.
2. 王興鵬, 李兆申, 袁耀宗.中國急性胰腺炎診治指南(2013, 上海)[J].中華胰腺病雜志, 2013, 33(4):73-78.
3. 中華醫學會感染病學分會肝衰竭與人工肝學組, 中華醫學會肝病學分會重型肝病與人工肝學組.肝衰竭診治指南(2012年版)[J].中華肝臟病雜志, 2013, 21(3):177-183.
4. Ranson JH. Etiological and prognostic factors in human acute pancreatitis:a review[J]. Am J Gastroenterol, 1982, 77(9):633-638.
5. Singh VK, Wu BU, Bollen TL, et al. A prospective evaluation of the bedside index for severity in acute pancreatitis score in assessing mortality and intermediate markers of severity in acute pancreatitis[J]. Am J Gastroenterol, 2009, 104(4):966-971.
6. 周圓圓, 楊麗, 廖忠莉, 等. BISAP與Ranson's評分對急性胰腺炎患者預后評估的比較[J].第三軍醫大學學報, 2012, 34(7):658-661.
7. Banks PA, Bollen TL, Ervenis C, et al. Classification of acute pancreatitis (2012):revision of the Atlanta classification and definitions by international consensus[J]. Gut, 2013, 62(1):102-111.
8. 張曉華, 李兆申, 許國銘, 等.急性胰腺炎肝臟損傷的表現及其發病機制的研究進展[J].第二軍醫大學學報, 2003, 24(10):1143-1145.
9. 王洪亮, 吳傳新.重癥急性胰腺炎時HMGB1與肝損害的關系[J].國際檢驗醫學雜志, 2011, 32(2):210-211.
10. He ZJ, Matikainen MP, Alho H, et al. Extrapancreatic organ impairment in caerulein induced pancreatitis[J]. Ann Chir Gynaecol, 1999, 88(2):112-117.
11. 李海燕, 陳瑞芬, 王民, 等.急性胰腺炎時胰、肺和肝微循環的形態觀察[J].電子顯微學報, 2004, 23(4):301-302.
12. Halonen KI, Pettila V, Leppaniemi AK, et al. Multiple organ dysfunction associated with severe acute pancreatitis[J]. Crit Care Med, 2002, 30(6):1274-1279.
13. 任文濤, 姜文弟, 張東海.急性胰腺炎并發肝損害的臨床分析[J].胰腺病學, 2005(1):43-44.
14. 高琦.重癥急性胰腺炎患者肝功能衰竭的相關危險因素分析[J].現代預防醫學, 2013, 40(19):3705-3707.
15. 熊琪山.急性胰腺炎合并肝損害50例臨床分析[J].華西醫學, 2004, 19(4):605.
16. 趙玲.急性胰腺炎合并肝損害32例臨床分析[J].中華腹部疾病雜志, 2005, 5(3):172-173.
17. 王孚軒.急性胰腺炎合并肝損害91例臨床分析[J].臨床醫學, 2009, 29:56-57.
18. 屈健寧, 蔡大川.急性胰腺炎合并肝損害152例臨床分析[J].重慶醫學, 2010, 39(5):549-550.
19. 徐路, 王青, 唐欣.急性胰腺炎合并肝損害32例臨床分析[J].重慶醫學, 2009, 38(1):120-121.
20. 龍慶林, 房殿春. 90例急性胰腺炎胰外損害臨床分析[J].重慶醫學, 2003, 32(1):63-64.
21. 黃漢明, 嚴友德.急性胰腺炎伴肝損害155例臨床研究[J].南京醫科大學學報:自然科學版, 2001, 21(4):371-372.
22. 李和平, 張秀琳.急性胰腺炎合并肝損害36例臨床分析[J].陜西醫學雜志, 2008, 37(7):848-849.
23. 吳康為, 吳金明, 林春景, 等.急性胰腺炎合并肝損害的臨床分析[J].溫州醫學院學報, 2008, 38(4):368-370.
24. 王艷平.急性胰腺炎肝功能損害81例分析[J].醫學理論與實踐, 2011, 24(22):2699-2700.
25. 陳佩.急性胰腺炎并肝損傷90例診治體會[J].山東醫藥, 2009, 49(22):70.
26. Wu BU, Johannes RS, Sun X, et al. The early prediction of mortality in acute pancreatitis:a large population-based study[J]. Gut, 2008, 57:1698-1703.
27. Papachristou GI, Muddana V, Yadav D, et al. Comparison of BISAP, Ranson's, APACHE-Ⅱ, and CTSI scores in predicting organ failure, complications, and mortality in acute pancreatitis[J]. Gastroenterology, 2010, 105(2):435-441.
28. 胡瑞瑞, 張琪, 田字彬. BISAP評分系統對重癥急性胰腺炎的評估價值[J].中華胰腺病雜志, 2011, 11(4):231-233.
29. 郭小燕, 萬榮, 徐萍, 等. BISAP評分對急性胰腺炎患者病情嚴重度及預后評估價值的研究[J].胃腸與肝臟病學雜志, 2012, 21(12):1097-1104.
30. 張偉, 單宏超, 郭善禹.急性胰腺炎病人急性肝功能損害[J].中華肝膽外科雜志, 2004, 10(4):225-227.

West China Medical Journal

Risk Factors of Acute Pancreatitis Associated with Hepatic Dysfunction

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