中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 37 Issue 5
May  2021
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2021  >  37(5): 1164-1168

Clinical and prognostic features of hypertriglyceridemic pancreatitis during pregnancy

DOI: 10.3969/j.issn.1001-5256.2021.05.036

  • Department of Gastroenterology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, China

  • Received Date: 2020-10-22
  • Accepted Date: 2020-11-27
  • Published Date: 2021-05-20
    Abstract
  •   Objective  To investigate the clinical and prognostic features of hypertriglyceridemic pancreatitis (HTGP) during pregnancy.  Methods  A total of 77 patients with acute pancreatitis in pregnancy who were admitted to The Affiliated Hospital of Southwest Medical University from January 2013 to June 2020 were enrolled as subjects, and according to the presence or absence of HTGP, they were divided into HTGP group with 38 patients and non-HTGP group with 39 patients. The two groups were compared in terms of the clinical features including age, pregnancy, laboratory markers, complication, and prognostic indices. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups, and the Mann-Whitney U test was used for comparison of ranked data between two groups. According to the trimester of pregnancy, the patients were divided into early pregnancy group with 4 patients, middle pregnancy group with 14 patients, and late pregnancy with 59 patients, and blood lipid levels were compared between groups; the Kruskal-Wallis H test was used for comparison between two groups or within each group.  Results  Compared with the non-HTGP group, the HTGP group had significantly higher mean age (t=-3.000, P=0.004) and proportion of patients with diabetes (χ2=8.867, P=0.003). Compared with the non-HTGP group, the HTGP group had a significantly higher proportion of patients with disease onset in the third trimester (P < 0.001) and a significantly lower serum level of sodium (Z=-6.328, P < 0.001). Compared with the non-HTGP group, the HTGP group had significantly higher incidence rates of acute peripancreatic fluid collection (76.3% vs 33.3%, χ2=14.342, P < 0.001) and systemic inflammatory response syndrome (81.6% vs 41.0%, χ2=13.310, P < 0.001). There were significant differences between the two groups in the length of hospital stay, the rate of admission to the intensive care unit, and hospital costs (Z=-2.077, χ2=11.537, Z=-3.525, all P < 0.05). The levels of total cholesterol and triglyceride in the third trimester were significantly higher than those in middle pregnancy (both P < 0.05).  Conclusion  Compared with the non-HTGP group, the HTGP group has a higher proportion of patients with disease onset in the third trimester of pregnancy, a higher risk of complications, a longer length of hospital stay, and higher hospital costs.

     

    • FullText(HTML)
  • loading
    • References(22)
  • [1]
    Pancreas Study Group, Chinese Society of Gastroenterology, Chinese Medical Association; Editorial Board of Chinese Journal of Pancreatology; Editorial Board of Chinese Journal of Digestion. Chinese guidelines for the management of acute pancreatitis (Shenyang, 2019)[J]. J Clin Hepatol, 2019, 35(12): 2706 -2711. DOI: 10.3969/j.issn.1001-5256.2019.12.013.

    中华医学会消化病学分会胰腺疾病学组, 《中华胰腺病杂志》编委会, 《中华消化杂志》编委会. 中国急性胰腺炎诊治指南(2019年, 沈阳)[J]. 临床肝胆病杂志, 2019, 35(12): 2706-2711. DOI: 10.3969/j.issn.1001-5256.2019.12.013.
    [2]
    LI HQ, LIU W, TANG J, et al. Evaluation value of triglyceride, C-reactive protein and procalcitonin on the severity and prognosis of hyperlipidemic acute pancreatitis[J]. Clin J Med Offic, 2019, 47(9): 923-925. DOI: 10.16680/j.1671-3826.2019.09.11.

    历海清, 刘卫, 唐郡, 等. 甘油三酯、C反应蛋白、降钙素原对高脂血症性急性胰腺炎病情严重程度及预后评估价值[J]. 临床军医杂志, 2019, 47(9): 923-925. DOI: 10.16680/j.1671-3826.2019.09.11.
    [3]
    HE Q, LYU D, CUI PL, et al. Analysis on the characteristics of clinical features of recurrent hyperlipidemic acute pancreatitis[J]. J Clin Exp Med, 2019, 18(6): 617-619. DOI: 10.3969/j.issn.1671-4695.2019.06.017.

    何强, 吕栋, 崔培林, 等. 复发性高脂血症性急性胰腺炎临床特点分析[J]. 临床和实验医学杂志, 2019, 18(6): 617-619. DOI: 10.3969/j.issn.1671-4695.2019.06.017.
    [4]
    ZHANG TT, LIU RX, YIN CH. Early diagnosis of acute pancreatitis in pregnancy[J]. J Clin Hepatol, 2020, 36(7): 1669-1672. DOI: 10.3969/j.issn.1001-5256.2020.07.050.

    张婷婷, 刘瑞霞, 阴赪宏. 妊娠期急性胰腺炎的早期诊断[J]. 临床肝胆病杂志, 2020, 36(7): 1669-1672. DOI: 10.3969/j.issn.1001-5256.2020.07.050.
    [5]
    BANKS PA, BOLLEN TL, DERVENIS 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. DOI: 10.1136/gutjnl-2012-302779.
    [6]
    Pancreas Study Group, Chinese Society of Gastroenterology, Chinese Medical Association, Editorial Board of Chinese Journal of Pancreatology, Editorial Board of Chinese Journal of Digestion. Chinese guidelines for the management of acute pancreatitis(2013, Shanghai)[J]. J Clin HepatoI, 2013, 29(9): 656-660. DOI: 10.3969/j.issn.1001-5256.2013.09.006.

    中华医学会消化病学分会胰腺疾病学组, 《中华胰腺病杂志》编辑委员会, 《中华消化杂志》编辑委员会. 中国急性胰腺炎诊治指南(2013年, 上海)[J]. 临床肝胆病杂志, 2013, 29(9): 656-660. DOI: 10.3969/j.issn.1001-5256.2013.09.006.
    [7]
    LU GT, WEI M, LI WQ. Research advances of hypertriglyceridemia acute pancreatitis[J]. Chin J Lab Med, 2020, 43(3): 336-340. DOI: 10.3760/cma.j.issn.1009-9158.2020.03.026.

    路国涛, 魏梅, 李维勤. 高甘油三酯血症性急性胰腺炎的研究进展[J]. 中华检验医学杂志, 2020, 43(3): 336-340. DOI: 10.3760/cma.j.issn.1009-9158.2020.03.026.
    [8]
    ADIAMAH A, PSALTIS E, CROOK M, et al. A systematic review of the epidemiology, pathophysiology and current management of hyperlipidaemic pancreatitis[J]. Clin Nutr, 2018, 37(6 Pt A): 1810-1822. DOI: 10.1016/j.clnu.2017.09.028.
    [9]
    MOSZTBACHER D, HANÁK L, FARKAS N, et al. Hypertriglyceridemia-induced acute pancreatitis: A prospective, multicenter, international cohort analysis of 716 acute pancreatitis cases[J]. Pancreatology, 2020, 20(4): 608-616. DOI: 10.1016/j.pan.2020.03.018.
    [10]
    TSUANG W, NAVANEETHAN U, RUIZ L, et al. Hypertriglyceridemic pancreatitis: Presentation and management[J]. Am J Gastroenterol, 2009, 104(4): 984-991. DOI: 10.1038/ajg.2009.27.
    [11]
    LUO L, ZEN H, XU H, et al. Clinical characteristics of acute pancreatitis in pregnancy: Experience based on 121 cases[J]. Arch Gynecol Obstet, 2018, 297(2): 333-339. DOI: 10.1007/s00404-017-4558-7.
    [12]
    AMIN T, POON LC, TEOH TG, et al. Management of hypertriglyceridaemia-induced acute pancreatitis in pregnancy[J]. J Matern Fetal Neonatal Med, 2015, 28(8): 954-958. DOI: 10.3109/14767058.2014.939064.
    [13]
    JIN J, YU YH, ZHONG M, et al. Analyzing and identifying risk factors for acute pancreatitis with different etiologies in pregnancy[J]. J Matern Fetal Neonatal Med, 2015, 28(3): 267-271. DOI: 10.3109/14767058.2014.913132.
    [14]
    PAPADAKIS EP, SARIGIANNI M, MIKHAILIDIS DP, et al. Acute pancreatitis in pregnancy: An overview[J]. Eur J Obstet Gynecol Reprod Biol, 2011, 159(2): 261-266. DOI: 10.1016/j.ejogrb.2011.07.037.
    [15]
    HUANG C, LIU J, LU Y, et al. Clinical features and treatment of hypertriglyceridemia-induced acute pancreatitis during pregnancy: A retrospective study[J]. J Clin Apher, 2016, 31(6): 571-578. DOI: 10.1002/jca.21453.
    [16]
    CAIN MA, ELLIS J, VENGROVE MA, et al. Gallstone and severe hypertriglyceride-induced pancreatitis in pregnancy[J]. Obstet Gynecol Surv, 2015, 70(9): 577-583. DOI: 10.1097/OGX.0000000000000216.
    [17]
    GOLDBERG AS, HEGELE RA. Severe hypertriglyceridemia in pregnancy[J]. J Clin Endocrinol Metab, 2012, 97(8): 2589-2596. DOI: 10.1210/jc.2012-1250.
    [18]
    JIN D, TAN J, JIANG J, et al. The early predictive value of routine laboratory tests on the severity of acute pancreatitis patients in pregnancy: A retrospective study[J]. Sci Rep, 2020, 10(1): 10087. DOI: 10.1038/s41598-020-66921-x.
    [19]
    NAKAO J, OHBA T, TAKAISHI K, et al. Omega-3 fatty acids for the treatment of hypertriglyceridemia during the second trimester[J]. Nutrition, 2015, 31(2): 409-412. DOI: 10.1016/j.nut.2014.09.006.
    [20]
    WANG XY, YANG L, WU MH. Diagnosis and treatment of pregnancy complicated with hyperlipidemic pancreatitis: A report of 12 case[J]. J Chin Physician, 2019, 21(1): 51-54. DOI: 10.3760/cma.j.issn.1008-1372.2019.01.014.

    王向阳, 杨丽, 吴明浩. 妊娠合并高脂血症性胰腺炎12例诊治分析[J]. 中国医师杂志, 2019, 21(1): 51-54. DOI: 10.3760/cma.j.issn.1008-1372.2019.01.014.
    [21]
    DONG LL, PEI JD, CHE RH, et al. Acute pancreatitis in pregnancy: An analysis of 42 cases[J]. J Tongji University(Medical Science), 2020, 41(4): 492-496. DOI: 10.16118/j.1008-0392.2020.04.016.

    董玲玲, 裴锦丹, 车荣华, 等. 妊娠合并急性胰腺炎42例的临床特征及诊疗分析[J]. 同济大学学报(医学版), 2020, 41(4): 492-496. DOI: 10.16118/j.1008-0392.2020.04.016.
    [22]
    WANG Y, ATTAR BM, ABU OMAR Y, et al. Pseudohyponatremia in hypertriglyceridemia-induced acute pancreatitis: A tool for diagnosis rather than merely a laboratory error?[J]. Pancreas, 2019, 48(1): 126-130. DOI: 10.1097/MPA.0000000000001192.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(4)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (621) PDF downloads(41) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return