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1、早期血浆置换治疗高脂血症性急性胰腺炎的临床意义【摘要】冃的探讨早期血浆置换(plasmaexchange,PE)对高脂血症性急性胰腺炎(acutehyperlipidemicpancreatitis,HLP)的治疗作用。方法将42例HLP患者随机分为两组，治疗组22例(常规治疗+早期PE),对照组20例采用常规治疗。比较PE两组患者血清甘油三酯(TG)浓度、急性生理和慢性健康评价指标II(APACHEII)评分、C-反应蛋白(CRP)浓度变化，并观察两组患者的临床表现和预后。结果入院24h,两组患者血清TG浓度较入院时均降低，且
2、治疗纽血清TG浓度明显低于对照组(P<0.01)；入院48h,治疗组APACHEII评分、CRP浓度均低于对照组(P=0.032；P二0.017)；治疗组患者腹痛、腹胀缓解时间，禁食水时间，住院时间均较对照组缩短(P〈0.01)；治疗组及对照组的病死率分别为9.1%、25.0%,两者比较差异无统计学意义(P二0.333)。结论早期PE可显著降低患者血清TG浓度，改善患者的临床症状，是治疗IILP的安全、冇效的手段Z—。【关键词】高脂血症性急性胰腺炎；血浆置换；甘油三酯Theclinicaleffectsoftheearlierp
3、lasmaexchangeinlhetreatmentofhyperlipidemicacutepancreatitisZHOUMing-yin,CHENTao,WANGYong-guang.TheCentralHospitalofXinYang,XinYang464000,China[Abstract]ObjectiveToevaluatetheeffectofearlierplasmaexchangeinthetreatmentofpatientswithThehyperlipidemicacutepanercatitis(
4、HLP)・Methods42pationtswithHLPweredividedinto2groups:thetreatmentgroup(22cases)wasgiventheconventionaltherapyandtheplasmaexchange；thecontrolgroup(20cases)wasgiventheonlyconventionaltherapy,andthenThetriglyceridelevelsinserum、thesorcesofacutephysiologyandchronichealthe
5、valuationIIaswellastheC-reactiveproteinlevelsinserumwerecomparedbeforeandaftertheplasmaexchangerespectively,theirclinicalfeaturesandprognosiswerealsoobserved・ResultsAfter24hoursinhospital,triglycerideserumlevelsreducedinbothgrouds,anddecreasedmoredistinctlyinthetreat
6、mentgroup(P<0>01).After48hours,boththesorcesofacutephysiologyandchronichealthevaluationIIandtheC-reactiveproteinlevelsinseruminthecontrolgroupweresinificantlyincreasedthanthoseofthetreatmentgroup(P二0.032；P=0・017).Thereleasetimeofabodominalpainanddistention、thetimeoff
7、astingandhospitaistayofthetreatmentgroupweresignificantlyshorterthanthatofthecontrolgroup(P〈0.01),themortalityofthetwogroupswere9.1%and25-0%respectively,hadnostatisticalsignificancefortheir(P二0・333)•ConelusionTheearlierplasmaexchangecouldquicklyandobviouslydeducesthe
8、triglycerideserumlevelsaswe11asimprovespatientsclinicalfeatures,whichisoneofthesafelyandavaiTabletools.【Keywords】Hyperlipidemicacut
