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.	陈红艳, 刘明新, 胡群帆, 等.急性胰腺炎患者的肝功能检测结果分析[J].国际检验医学杂志, 2010, 31(3):301.
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3.	中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会肝病学分会重型肝病与人工肝学组.肝衰竭诊治指南(2012年版)[J].中华肝脏病杂志, 2013, 21(3):177-183.
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6.	周圆圆, 杨丽, 廖忠莉, 等. BISAP与Ranson's评分对急性胰腺炎患者预后评估的比较[J].第三军医大学学报, 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.	张晓华, 李兆申, 许国铭, 等.急性胰腺炎肝脏损伤的表现及其发病机制的研究进展[J].第二军医大学学报, 2003, 24(10):1143-1145.
9.	王洪亮, 吴传新.重症急性胰腺炎时HMGB1与肝损害的关系[J].国际检验医学杂志, 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, 陈瑞芬, 王民, 等.急性胰腺炎时胰、肺和肝微循环的形态观察[J].电子显微学报, 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.	任文涛, 姜文弟, 张东海.急性胰腺炎并发肝损害的临床分析[J].胰腺病学, 2005(1):43-44.
14.	高琦.重症急性胰腺炎患者肝功能衰竭的相关危险因素分析[J].现代预防医学, 2013, 40(19):3705-3707.
15.	熊琪山.急性胰腺炎合并肝损害50例临床分析[J].华西医学, 2004, 19(4):605.
16.	赵玲.急性胰腺炎合并肝损害32例临床分析[J].中华腹部疾病杂志, 2005, 5(3):172-173.
17.	王孚轩.急性胰腺炎合并肝损害91例临床分析[J].临床医学, 2009, 29:56-57.
18.	屈健宁, 蔡大川.急性胰腺炎合并肝损害152例临床分析[J].重庆医学, 2010, 39(5):549-550.
19.	徐路, 王青, 唐欣.急性胰腺炎合并肝损害32例临床分析[J].重庆医学, 2009, 38(1):120-121.
20.	龙庆林, 房殿春. 90例急性胰腺炎胰外损害临床分析[J].重庆医学, 2003, 32(1):63-64.
21.	黄汉明, 严友德.急性胰腺炎伴肝损害155例临床研究[J].南京医科大学学报:自然科学版, 2001, 21(4):371-372.
22.	李和平, 张秀琳.急性胰腺炎合并肝损害36例临床分析[J].陕西医学杂志, 2008, 37(7):848-849.
23.	吴康为, 吴金明, 林春景, 等.急性胰腺炎合并肝损害的临床分析[J].温州医学院学报, 2008, 38(4):368-370.
24.	王艳平.急性胰腺炎肝功能损害81例分析[J].医学理论与实践, 2011, 24(22):2699-2700.
25.	陈佩.急性胰腺炎并肝损伤90例诊治体会[J].山东医药, 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, 张琪, 田字彬. BISAP评分系统对重症急性胰腺炎的评估价值[J].中华胰腺病杂志, 2011, 11(4):231-233.
29.	郭小燕, 万荣, 徐萍, 等. BISAP评分对急性胰腺炎患者病情严重度及预后评估价值的研究[J].胃肠与肝脏病学杂志, 2012, 21(12):1097-1104.
30.	张伟, 单宏超, 郭善禹.急性胰腺炎病人急性肝功能损害[J].中华肝胆外科杂志, 2004, 10(4):225-227.

1. 陈红艳, 刘明新, 胡群帆, 等.急性胰腺炎患者的肝功能检测结果分析[J].国际检验医学杂志, 2010, 31(3):301.
2. 王兴鹏, 李兆申, 袁耀宗.中国急性胰腺炎诊治指南(2013, 上海)[J].中华胰腺病杂志, 2013, 33(4):73-78.
3. 中华医学会感染病学分会肝衰竭与人工肝学组, 中华医学会肝病学分会重型肝病与人工肝学组.肝衰竭诊治指南(2012年版)[J].中华肝脏病杂志, 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. 周圆圆, 杨丽, 廖忠莉, 等. BISAP与Ranson's评分对急性胰腺炎患者预后评估的比较[J].第三军医大学学报, 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. 张晓华, 李兆申, 许国铭, 等.急性胰腺炎肝脏损伤的表现及其发病机制的研究进展[J].第二军医大学学报, 2003, 24(10):1143-1145.
9. 王洪亮, 吴传新.重症急性胰腺炎时HMGB1与肝损害的关系[J].国际检验医学杂志, 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, 陈瑞芬, 王民, 等.急性胰腺炎时胰、肺和肝微循环的形态观察[J].电子显微学报, 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. 任文涛, 姜文弟, 张东海.急性胰腺炎并发肝损害的临床分析[J].胰腺病学, 2005(1):43-44.
14. 高琦.重症急性胰腺炎患者肝功能衰竭的相关危险因素分析[J].现代预防医学, 2013, 40(19):3705-3707.
15. 熊琪山.急性胰腺炎合并肝损害50例临床分析[J].华西医学, 2004, 19(4):605.
16. 赵玲.急性胰腺炎合并肝损害32例临床分析[J].中华腹部疾病杂志, 2005, 5(3):172-173.
17. 王孚轩.急性胰腺炎合并肝损害91例临床分析[J].临床医学, 2009, 29:56-57.
18. 屈健宁, 蔡大川.急性胰腺炎合并肝损害152例临床分析[J].重庆医学, 2010, 39(5):549-550.
19. 徐路, 王青, 唐欣.急性胰腺炎合并肝损害32例临床分析[J].重庆医学, 2009, 38(1):120-121.
20. 龙庆林, 房殿春. 90例急性胰腺炎胰外损害临床分析[J].重庆医学, 2003, 32(1):63-64.
21. 黄汉明, 严友德.急性胰腺炎伴肝损害155例临床研究[J].南京医科大学学报:自然科学版, 2001, 21(4):371-372.
22. 李和平, 张秀琳.急性胰腺炎合并肝损害36例临床分析[J].陕西医学杂志, 2008, 37(7):848-849.
23. 吴康为, 吴金明, 林春景, 等.急性胰腺炎合并肝损害的临床分析[J].温州医学院学报, 2008, 38(4):368-370.
24. 王艳平.急性胰腺炎肝功能损害81例分析[J].医学理论与实践, 2011, 24(22):2699-2700.
25. 陈佩.急性胰腺炎并肝损伤90例诊治体会[J].山东医药, 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, 张琪, 田字彬. BISAP评分系统对重症急性胰腺炎的评估价值[J].中华胰腺病杂志, 2011, 11(4):231-233.
29. 郭小燕, 万荣, 徐萍, 等. BISAP评分对急性胰腺炎患者病情严重度及预后评估价值的研究[J].胃肠与肝脏病学杂志, 2012, 21(12):1097-1104.
30. 张伟, 单宏超, 郭善禹.急性胰腺炎病人急性肝功能损害[J].中华肝胆外科杂志, 2004, 10(4):225-227.

West China Medical Journal

Risk Factors of Acute Pancreatitis Associated with Hepatic Dysfunction

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