PDF(Pubmed)
Abstract：
UNASSIGNED: Both insulin and plasma exchange (PE) are used in hypertriglyceridemic acute pancreatitis (HTG-AP). Our aim was to compare the efficacy of both treatments.
UNASSIGNED: A randomized, parallel group study performed in a tertiary hospital in 22 HTG-AP patients with non-severe prognosis and triglycerides between 15 and 40 mmol/L. Patients were randomized to daily PE or insulin infusion until triglycerides were <10 mmol/L. Primary outcome was % reduction in triglycerides within 24 h. Secondary outcomes were days needed to lower triglycerides <10 mmol/L, highest CRP and percentage of patients with a severe course of pancreatitis.
UNASSIGNED: There was a trend toward a greater decrease in triglycerides within the first 24 h in the PE group (67 ± 17% vs. 53 ± 17%, p = 0.07), but the absolute difference was modest [mean difference of 6 mmol/L (14% of initial value)]. Triglycerides fell below 10 mmol/L in a median (IQR) of 1 (1-2) and 2 (1-2) days, respectively (p = 0.25). Secondary outcomes related to disease severity were also comparable: highest CRP 229 vs. 211 mg/L (p = 0.69) and severe course of pancreatitis in 2/11 cases in both groups (p = 1.0). Regarding treatment complications, there was one mild hypoglycemia and one allergic reaction during PE. Survival was 100% in both groups.
UNASSIGNED: There was no significant difference, but only a trend toward a greater decrease in triglycerides with PE, and the clinical course was also comparable. These results do not support universal use of PE in patients with HTG-AP.
UNASSIGNED: [ClinicalTrials.gov], identifier [NCT02622854].
UNASSIGNED: A randomized, parallel group study performed in a tertiary hospital in 22 HTG-AP patients with non-severe prognosis and triglycerides between 15 and 40 mmol/L. Patients were randomized to daily PE or insulin infusion until triglycerides were <10 mmol/L. Primary outcome was % reduction in triglycerides within 24 h. Secondary outcomes were days needed to lower triglycerides <10 mmol/L, highest CRP and percentage of patients with a severe course of pancreatitis.
UNASSIGNED: There was a trend toward a greater decrease in triglycerides within the first 24 h in the PE group (67 ± 17% vs. 53 ± 17%, p = 0.07), but the absolute difference was modest [mean difference of 6 mmol/L (14% of initial value)]. Triglycerides fell below 10 mmol/L in a median (IQR) of 1 (1-2) and 2 (1-2) days, respectively (p = 0.25). Secondary outcomes related to disease severity were also comparable: highest CRP 229 vs. 211 mg/L (p = 0.69) and severe course of pancreatitis in 2/11 cases in both groups (p = 1.0). Regarding treatment complications, there was one mild hypoglycemia and one allergic reaction during PE. Survival was 100% in both groups.
UNASSIGNED: There was no significant difference, but only a trend toward a greater decrease in triglycerides with PE, and the clinical course was also comparable. These results do not support universal use of PE in patients with HTG-AP.
UNASSIGNED: [ClinicalTrials.gov], identifier [NCT02622854].
摘要：
未经证实：胰岛素和血浆交换（PE）均用于高甘油三酯性急性胰腺炎（HTG-AP）。我们的目的是比较两种治疗方法的疗效。
未经批准：随机，在三级医院对22例非严重预后且甘油三酯在15至40mmol/L之间的HTG-AP患者进行了平行组研究。患者随机接受每日PE或胰岛素输注，直到甘油三酯<10mmol/L。主要结果是24小时内甘油三酯的减少百分比。次要结果是降低甘油三酯<10mmol/L所需的天数。最高的CRP和重症胰腺炎患者的百分比。
UNASSIGNED：PE组的前24小时内甘油三酯下降幅度更大（67±17％vs.53±17%，p=0.07),但绝对差异不大[平均差为6mmol/L（初始值的14％）]。甘油三酯在1（1-2）和2（1-2）天的中位数（IQR）中降至10mmol/L以下，分别(p=0.25)。与疾病严重程度相关的次要结局也具有可比性：最高CRP229与211mg/L（p=0.69），2/11例胰腺炎严重病程（p=1.0）。关于治疗并发症，PE期间有1例轻度低血糖和1例过敏反应.两组的生存率均为100%。
未经评估：没有显著差异，但只有一种趋势是用PE减少甘油三酯，临床过程也相当。这些结果不支持在HTG-AP患者中普遍使用PE。
未经评估：[ClinicalTrials.gov]，标识符[NCT02622854]。
未经批准：随机，在三级医院对22例非严重预后且甘油三酯在15至40mmol/L之间的HTG-AP患者进行了平行组研究。患者随机接受每日PE或胰岛素输注，直到甘油三酯<10mmol/L。主要结果是24小时内甘油三酯的减少百分比。次要结果是降低甘油三酯<10mmol/L所需的天数。最高的CRP和重症胰腺炎患者的百分比。
UNASSIGNED：PE组的前24小时内甘油三酯下降幅度更大（67±17％vs.53±17%，p=0.07),但绝对差异不大[平均差为6mmol/L（初始值的14％）]。甘油三酯在1（1-2）和2（1-2）天的中位数（IQR）中降至10mmol/L以下，分别(p=0.25)。与疾病严重程度相关的次要结局也具有可比性：最高CRP229与211mg/L（p=0.69），2/11例胰腺炎严重病程（p=1.0）。关于治疗并发症，PE期间有1例轻度低血糖和1例过敏反应.两组的生存率均为100%。
未经评估：没有显著差异，但只有一种趋势是用PE减少甘油三酯，临床过程也相当。这些结果不支持在HTG-AP患者中普遍使用PE。
未经评估：[ClinicalTrials.gov]，标识符[NCT02622854]。
