Abstract：
BACKGROUND: The worldwide incidence of acute pancreatitis (AP) is increasing, but the dominant etiology of AP may vary by country. Mixed etiologies are involved in the increase in the number of AP patients.
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.
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.
摘要：
背景：急性胰腺炎（AP）的全球发病率正在增加，但AP的主要病因可能因国家而异。混合病因与AP患者数量的增加有关。
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.
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.
