Analysis To Etiology Feature And Prognostic Risk Factor Of 603 Patients With Acute Pancreatitis (AP) In YanBian Area

ObjectiveTo investigate the etiology feature and prognostic risk factor of 603 patients with Acute Pancreatitis (AP) in YanBian area.The present study woule be useful to prevention, treatment and experiment study for this disease.Methods1.The cases of 603 with AP in Yanbian university hospital from January 2000 to December 2009 were used to retrospective analysis.2. According to the etiological factor, the AP patients were divided into biliary group, alcohol group, dietary factors group, hyperlipidemia group, abdominal postoperative group, other factor group and idiopathic group. To survey the composition of the each group. To analyze the etiological factor of different gender, ethnicity, ages, AP type and onset period.The cases from January 2000 to December 2004 were set to group A,and the cases from January 2005 to December 2009 were set to group B.3.The 127 cases of SAP which therapeutic results were definite were used to investigate the prognostic risk factor of AP. The 127 cases were divided into the survival group and death group by discharge. To survey the cause of death. After collecting index with clinical signs, etiological factor and results of the first laboratory tests within 24 hours of the two group patients, performed the correlation analysis and obtained prognostic risk factors.Results1. The etiology feature of AP:(1) The composition of etiological factor:The etiological factor of 183 cases (30.3%) was alcohol. The etiological factor of 160 cases (26.5%) was biliary. The etiological factor of 147 cases (24.4%) was idiopathic. The etiological factor of 41 cases (6.8%) was dietary factors. The etiological factor of 26 cases (4.3%) was abdominal postoperative.The etiological factor of 25 cases (4.2%) was hyperlipidemia. The etiological factor of 21 cases (3.5%) was other factor,such as medicine, infection, wound, and so on. The primary etiological factor of AP was alcohol.(2) Gender to etiological factor of AP:The male-to-female ratio was 1:0.46. The male cases of Alcohol AP were significantly higher than the female cases (P< 0.05).The female cases of biliary and idiopathic AP were significantly higher than the male cases (P<0.05)(3) Ethnic to etiological factor of AP:The Korean-to-Chinese ratio was 1:0.98. Chinese cases of Hyperlipidemia AP were significantly higher than Korean cases (P <0.05).(4) Age to etiological factor of AP:The highest age of onset was 36～50(266 cases, 44.1%). The primary etiological factor of≦20-year-old was idiopathic. The primary etiological factor of 21～50-year-old was alcohol. The primary etiological factor of over 50-year-old-year-old was biliary.(5) Type to etiological factor of AP:The composition of etiological factor in MAP and SAP was no significant difference (P>0.05).(6) Onset period to etiological factor of AP:The cases of idiopathic in group A was significantly higher than these in group B (P<0.05)2. Prognostic risk factors of SAP:The survival group was 110 cases (86.6%) of SAP patients,and the died group was 17 cases (13.4%) of SAP patients. The causes of death in died group were multiple organ dysfunction syndrome(13cases), pancreatic encephalopathy(2cases), cardiac shock(1cases), septic shock(1cases).The gender, age, ethnic and etiological factor of two groups were no significant difference (P>0.05) The indexes of heart rate, respiratory rate, systolic blood pressure, serum albumin, serum creatinine, glucose, calcium, phosphorus and arterial partial pressure of oxygen in the died group were significant difference (P<0.05) than these in the survival group. Three variables (systolic blood pressure, arterial partial pressure of oxygen and albumin) were selected by multivariate Logistic regression analysis. Arterial partial pressure of oxygen P=0.047 (P<0.05), which could be regarded as an independent risk factor of death in SAP patients.Conclusion1. Alcoholic and biliary were the major etiological factors of 603 AP patients in this area. Alcoholic was the major etiological factors of young male AP patients. Biliary was the major etiological factors of old female AP patients. Idiopathic AP became a trend to diminish in recent years.2. Multiple Organ Dysfunction Syndrome (MODS) was the major cause of death in patients with SAP.3. Arterial partial pressure of oxygen in 24 hours of admission was the independent risk factor for evaluating the prognosis of severe acute pancreatitis.