目的:分析慢性酒精性胰腺炎(ARP)和慢性非ARP患者胃饥饿素(Gh)、胃泌素释放多肽(GRP)和血管活性肠肽(VIP)水平及临床应用价值。方法:本院2018-01—2018-12收治的慢性胰腺炎患者共82例,依据病因分为ARP组(33例)和非ARP组(49例)。采用ELIS...目的:分析慢性酒精性胰腺炎(ARP)和慢性非ARP患者胃饥饿素(Gh)、胃泌素释放多肽(GRP)和血管活性肠肽(VIP)水平及临床应用价值。方法:本院2018-01—2018-12收治的慢性胰腺炎患者共82例,依据病因分为ARP组(33例)和非ARP组(49例)。采用ELISA检测两组患者血清Gh、GRP和VIP三种胃肠激素以及胰蛋白酶和胰糜蛋白酶两种胰酶水平并比较两组间各指标的差异。应用Pearson线性相关分析Gh、GRP、VIP与胰蛋白酶和胰糜蛋白酶水平的相关性。应用ROC曲线分析Gh、GRP、VIP、胰蛋白酶和胰糜蛋白酶对ARP的诊断价值。采用Logistic回归分析Gh、GRP和VIP水平与ARP的关系。结果:ARP组血清Gh水平明显高于非ARP组(9.33±4.21ng/ml vs 6.61±3.98ng/ml,P<0.01)。Pearson相关性分析提示Gh与胰蛋白酶和胰糜蛋白酶水平均呈正相关,相关系数分别为0.495、0.451(P<0.01)。ROC曲线提示Gh对于ARP的诊断意义最高,AUC为0.807,95%CI为0.745-0.870,cut-off值为12.43ng/ml,敏感度82.12%,特异度84.61%。Losgistic回归分析提示Gh>12.43ng/ml(模型1:OR=1.55,95%CI 1.06—1.95;模型2:OR=1.87,95%CI 1.12—2.35,P均<0.05)为ARP的独立危险因素。结论:ARP患者Gh水平明显升高,该指标有助于ARP的诊断,是ARP的独立危险因素。展开更多
Objective. Unlike patients with alcoholic hepatitis, patients with acute alcoholic pancreatitis seldom come into the hospital in an intoxicated state. Long-term history of heavy drinking induces increases in the serum...Objective. Unlike patients with alcoholic hepatitis, patients with acute alcoholic pancreatitis seldom come into the hospital in an intoxicated state. Long-term history of heavy drinking induces increases in the serum pancreatic enzymes and pancreatitis-associated protein profiles during the withdrawal period. The aim of this study was to investigate the role of withdrawal in triggering acute alcoholic pancreatitis by studying the time-course of development of the first symptoms of the first acute alcoholic pancreatitis. Material and methods. One hundred patients (85 M, 15 F, mean age 46, range 18-73 years) with the first acute alcoholic pancreatitis were asked three different questions in an attempt to clarify the same issue: Had you already stopped continuous drinking before the start of the acute abdominal pain that later led to hospitalization? Had you already stopped continuous drinking before you started to experience nausea or vomiting? How many hours after taking the last drop of alcohol did you start to feel pain (0 h, 1 < 6 h, 7-12 h, 13-24 h, 25-48 h, > 48 h)? The amount of alcohol consumed was evaluated 1) during the past week and 2) during the past 2 months. The severity of the pancreatitis was assessed by serum C-reactive protein concentration, presence of necrosis, the development of pancreatic complications and the length of stay in hospital and in the intensive care unit. Results. Eighty-five patients were able to respond to the questions. Of these, 69% had developed pain and 91% nausea/vomiting only after they had already stopped continuous drinking. Whereas 29% of the patients developed some symptoms before stopping drinking, the majority of the patients developed symptoms during the first day after cessation (43% ) or later (28% ), mainly during the second day of cessation of drinking. In both the univariate analysis and the multivariate analysis the timing of the symptoms was dependent on the amount of alcohol consumed during the previous 2 months and in the past week. Conclusions. In the majority of patients with first acute alcoholic pancreatitis, the symptoms begin during the early withdrawal period. The withdrawal period might be more important than previously emphasized in the development of acute alcoholic pancreatitis.展开更多
文摘目的:分析慢性酒精性胰腺炎(ARP)和慢性非ARP患者胃饥饿素(Gh)、胃泌素释放多肽(GRP)和血管活性肠肽(VIP)水平及临床应用价值。方法:本院2018-01—2018-12收治的慢性胰腺炎患者共82例,依据病因分为ARP组(33例)和非ARP组(49例)。采用ELISA检测两组患者血清Gh、GRP和VIP三种胃肠激素以及胰蛋白酶和胰糜蛋白酶两种胰酶水平并比较两组间各指标的差异。应用Pearson线性相关分析Gh、GRP、VIP与胰蛋白酶和胰糜蛋白酶水平的相关性。应用ROC曲线分析Gh、GRP、VIP、胰蛋白酶和胰糜蛋白酶对ARP的诊断价值。采用Logistic回归分析Gh、GRP和VIP水平与ARP的关系。结果:ARP组血清Gh水平明显高于非ARP组(9.33±4.21ng/ml vs 6.61±3.98ng/ml,P<0.01)。Pearson相关性分析提示Gh与胰蛋白酶和胰糜蛋白酶水平均呈正相关,相关系数分别为0.495、0.451(P<0.01)。ROC曲线提示Gh对于ARP的诊断意义最高,AUC为0.807,95%CI为0.745-0.870,cut-off值为12.43ng/ml,敏感度82.12%,特异度84.61%。Losgistic回归分析提示Gh>12.43ng/ml(模型1:OR=1.55,95%CI 1.06—1.95;模型2:OR=1.87,95%CI 1.12—2.35,P均<0.05)为ARP的独立危险因素。结论:ARP患者Gh水平明显升高,该指标有助于ARP的诊断,是ARP的独立危险因素。
文摘Objective. Unlike patients with alcoholic hepatitis, patients with acute alcoholic pancreatitis seldom come into the hospital in an intoxicated state. Long-term history of heavy drinking induces increases in the serum pancreatic enzymes and pancreatitis-associated protein profiles during the withdrawal period. The aim of this study was to investigate the role of withdrawal in triggering acute alcoholic pancreatitis by studying the time-course of development of the first symptoms of the first acute alcoholic pancreatitis. Material and methods. One hundred patients (85 M, 15 F, mean age 46, range 18-73 years) with the first acute alcoholic pancreatitis were asked three different questions in an attempt to clarify the same issue: Had you already stopped continuous drinking before the start of the acute abdominal pain that later led to hospitalization? Had you already stopped continuous drinking before you started to experience nausea or vomiting? How many hours after taking the last drop of alcohol did you start to feel pain (0 h, 1 < 6 h, 7-12 h, 13-24 h, 25-48 h, > 48 h)? The amount of alcohol consumed was evaluated 1) during the past week and 2) during the past 2 months. The severity of the pancreatitis was assessed by serum C-reactive protein concentration, presence of necrosis, the development of pancreatic complications and the length of stay in hospital and in the intensive care unit. Results. Eighty-five patients were able to respond to the questions. Of these, 69% had developed pain and 91% nausea/vomiting only after they had already stopped continuous drinking. Whereas 29% of the patients developed some symptoms before stopping drinking, the majority of the patients developed symptoms during the first day after cessation (43% ) or later (28% ), mainly during the second day of cessation of drinking. In both the univariate analysis and the multivariate analysis the timing of the symptoms was dependent on the amount of alcohol consumed during the previous 2 months and in the past week. Conclusions. In the majority of patients with first acute alcoholic pancreatitis, the symptoms begin during the early withdrawal period. The withdrawal period might be more important than previously emphasized in the development of acute alcoholic pancreatitis.
