Clinical Characteristics Of Severe Acute Pancreatitis Patients With Different Serum Triglyceride Levels

Objective: To investigate the clinical characteristics of severe acute pancreatitis(SAP)patients with different serum triglyceride(TG)levels.Methods: From January 2016 to December 2020,142 patients with SAP admitted to the Second Hospital of Hebei Medical University were divided into two groups according to the serum TG level: The normal TG group with TG < 1.7 mmol/L and the TG elevated group with TG ≥1.7 mmol/L;Then the patients in the TG elevated group were divided into 2 subgroups according to the degree of TG elevation,namely,mild-to-moderate group with1.7mmol/L≤TG<11.3mmol/L group and severely elevated group with TG≥11.3mmol/L.This study statistically analyzed the patient’s age,gender,serum TG,serum total cholesterol(TC),serum C-reactive protein(CRP),blood glucose(Glu),Blood calcium(Ca),hydrothorax and(or)ascites,multiple organ dysfunction syndrome(MODS),surgical intervention,length of stay in hospital,death and other related data,to explore the different serum TG levels of SAP patients Clinical characteristics.Results: 1.Most SAP patients in the TG elevated group and the normal group were male patients(male: female ≈ 2:1).The age of SAP patients in the elevated TG group was younger than that in the normal group,and there was a statistical difference(P<0.05).Compared with the normal TG group,the serum TC level in the elevated TG group was higher(P<0.05),the blood Glu level was higher(P<0.05),the blood Ca level was lower(P<0.05),and the incidence of MODS was higher(P<0.05),the difference is statistically significant.There was no significant difference between the two groups in terms of serum CRP,hydrothorax/ascites ratio,surgical intervention ratio,hospital stay,and mortality rate(P>0.05).2.The two subgroups of SAP patients are mostly male patients(male: female ≈ 2:1).The age of SAP patients in the severely elevated TG group was slightly younger than that in the mild-to-moderate elevated group,but it was not statistically significant(P>0.05).Severely elevated TG group had higher serum TC levels(P<0.05),higher blood Glu levels(P<0.05),and higher incidence of MODS(P<0.05)in SAP patients then in the mild-to-moderate group,and the difference was statistically significant.However,there were no significant differences in serum CRP,blood Ca,hydrothorax/ascites ratio,surgical intervention ratio,length of hospital stay,and fatality rate between the severely elevated TG group and the mild-to-moderate group(P>0.05).3.In this study,the receiver operating characteristic(ROC)curve was used to evaluate the predictive ability of serum TG,TC,CRP,blood Glu,and Ca on the poor prognosis of SAP patients with MODS.The results showed: CRP(P<0.01,area under the curve(AUC)=0.94,95%CI: 0.89～0.98),TG(P<0.01,AUC=0.68,95%CI:0.58～0.78),TC(P<0.05,AUC=0.62,95%CI: 0.51～0.71)has a good predictive value for the poor prognosis MODS of SAP patients,and the best predictive cut-off values are 203.70 mg/L,5.59 mmol/L,5.05mmol/L.4.In this study,Spearman correlation analysis was used to analyze the correlation between TG and TC,CRP,Glu,and Ca.The results showed: TG level and TC(r=0.74,P<0.01),Glu(r=0.38,P<0.01),CRP(r=0.17,P<0.05)levels were positively correlated,and Ca(r=-0.36,P<0.01)levels were negatively correlated.Conclusion: Serum TG levels can affect the clinical indicators of SAP patients.SAP patients with elevated TG levels have a higher incidence of MODS.SAP patients with serum TG>5.59mmol/L are more likely to have adverse prognosis such as MODS.