OBJECTIVE: This study was to analyze the etiological changes and prognosis of AP patients and explore the prognosis of AP patients with mixed etiologies.
METHODS: Using a retrospective analysis method, AP patients hospitalized from January 2007 to December 2021 were selected from a pancreatic center in Nanchang, China. Trends in the main etiologies were analyzed, and the severity and prognosis of different etiologies were compared.
RESULTS: A total of 10,071 patients were included. Cholelithiasis (56.0%), hyperlipidemia (25.3%), and alcohol (6.5%) were the top three etiologies. The proportion of acute biliary pancreatitis (ABP) showed a decreasing trend, while the proportion of hypertriglyceridemic pancreatitis (HTGP) and alcoholic AP showed an increasing trend (all ptrend < 0.001). The incidence of organ failure and necrotizing pancreatitis was higher in patients with HTGP than in those with AP induced by other etiologies (all p < 0.05). There was no statistically significant difference in mortality among patients with different etiologies. Patients with AP due to a mixed hypertriglyceridemia-alcoholic etiology had higher ICU admission rates and were more severe than those with AP induced by other mixed etiologies.
CONCLUSIONS: In the past 15 years, the proportion of ABP has trended downward, while those of HTGP and alcoholic AP have risen. Among patients with mixed etiologies, those with a mixed hypertriglyceridemia-alcoholic etiology had a worse prognosis.
目的:本研究分析AP患者的病因学改变及预后,探讨混合病因AP患者的预后。
方法:采用回顾性分析方法,2007年1月至2021年12月住院的AP患者从南昌市胰腺中心选择,中国。分析了主要病因的趋势,比较不同病因的严重程度和预后。
结果:共纳入10,071例患者。胆石症(56.0%),高脂血症(25.3%),酒精(6.5%)是三大病因。急性胆源性胰腺炎(ABP)比例呈下降趋势,而高甘油三酯性胰腺炎(HTGP)和酒精性AP的比例呈上升趋势(所有ptend<0.001)。HTGP患者的器官功能衰竭和坏死性胰腺炎的发生率高于其他病因引起的AP患者(均p<0.05)。不同病因患者的死亡率差异无统计学意义。由于混合的高甘油三酯血症-酒精病因引起的AP患者的ICU入院率较高,并且比其他混合病因引起的AP患者更严重。
结论:在过去的15年里,ABP的比例呈下降趋势,而HTGP和酒精AP的上升。在混合病因的患者中,高甘油三酯血症-酒精混合病因学患者的预后较差.