外科理论与实践 ›› 2023, Vol. 28 ›› Issue (05): 448-453.doi: 10.16139/j.1007-9610.2023.05.10

• 论著 • 上一篇    下一篇

双重滤过血浆置换对高脂血症性急性胰腺炎的疗效分析

葛焱, 王国鑫, 王佳卉, 安源, 赵冰, 盛慧球, 马丽()   

  1. 上海交通大学医学院附属瑞金医院急诊科,上海 200025
  • 收稿日期:2023-08-16 出版日期:2023-09-25 发布日期:2024-01-04
  • 通讯作者: 马丽 E-mail:malipostgraduate2@163.com

Analysis of the effect of double filtration plasmapheresis on hyperlipidemic acute pancreatitis

GE Yan, WANG Guoxin, WANG Jiahui, AN Yuan, ZHAO Bing, SHENG Huiqiu, MA Li()   

  1. Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
  • Received:2023-08-16 Online:2023-09-25 Published:2024-01-04

摘要:

目的:评估双重滤过血浆置换(double filtration plasmapheresis, DFPP)对高脂血症性急性胰腺炎(hyperlipidemic acute pancreatitis, HL-AP)的疗效。方法:收集2019年1月至2022年5月入院的高脂血症性重症和中度重症急性胰腺炎病人的临床数据,按照治疗方式分为接受常规治疗的对照组和DFPP组,分析治疗后7 d内的临床数据。结果:与对照组相比,DFPP组血清甘油三酯(triglyceride, TG),丙氨酸转氨酶和天冬氨酸转氨酶在入组第1、2天显著降低,估计肾小球滤过率在第1、2、3、5天升高。白细胞和中性粒细胞数量在第1、2天降低,血红蛋白在第1、2、3天降低,C反应蛋白在第1、2、3、5、7天降低,DFPP组接受机械通气的病人减少。结论:与常规治疗方法相比,DFPP可更快降低TG,改善肺、肝、肾功能,降低炎症指标,并有利于早期液体复苏。

关键词: 高脂血症性急性胰腺炎, 双重滤过血浆置换, 多器官功能障碍综合征

Abstract:

Objective To evaluate the effect of double filtration plasmapheresis (DFPP) on patients with hyperlipidemic acute pancreatitis (HL-AP). Methods The clinical data of the patients with hyperlipidemic severe acute pancreatitis (HL-SAP) or moderately severe acute pancreatitis (HL-MSAP) from January 2019 to May 2022 were collected. The patients were divided into two groups,the control group received conventional treatment, DFPP group received DFPP treatment on the basis of conventional treatment. Results Compared with the control group, the following parameters changed significantly in DFPP group, triglyceride (TG), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) decreased on day 1 and 2, estimated glomerular filtration rate (eGFR) increased on day 1, 2, 3 and 5, leukocyte and neutrophil counts decreased on day 1 and 2, hemoglobin (HGB) decreased on day 1, 2, and 3, C-reactive protein (CRP) decreased on day 1, 2, 3, 5, and 7. And the patients in DFPP group receiving mechanical ventilation decreased compared with that in control group. Conclusion Compared with conventional treatment, DFPP can reduce plasma TG faster, improve lung, liver and kidney function, reduce inflammatory markers, and facilitate early fluid recovery.

Key words: Hyperlipidemic acute pancreatitis, Double filtration plasmapheresis, Multiple organ dysfunction syndrome

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