Clinical Characteristics Analysis Of Different Etiology Of Severe Acute Pancreatitis

Objective to study the clinical features of three common etiology of severe acute pancreatitis(SAP),and analyze the differences and similarities between the three clinical features,so as to provide theoretical basis for the clinical diagnosis and treatment of the disease.Methods: The general data of 268 cases of SAP patients admitted to the Minda Hospital of Hubei Minzu University from February2015 to February 2020 were collected,and 198 eligible patients with SAP were screened out,including 86 cases of Severe acute biliary pancreatitis,75 cases of hypertlipidemic severe acute pancreatitis and 37 cases of Severe alcoholic acute pancreatitis.The general data,laboratory indicators,imaging data,concomitant diseases,local and systemic complications,severity and prognosis of patients in the three groups were compared,and statistical software was used for processing,and the results were compared and analyzed.Results: 1.Age and male proportion in SABP group were significantly higher than those in HL-SAP group and SAAP group(P<0.05),male proportion in the HL-SAP group was significantly higher than that in the SABP group;BMI of HL-SAP group was significantly higher than that of the other two groups(P<0.05),BMI of SAAP group was significantly higher than that of SABP group(P<0.05).2.There was no significant difference in hypertension between the three groups(P>0.05).The prevalence of diabetes in HL-SAP group was significantly higher than that in SABP group(P<0.05).The prevalence of fatty liver in HL-SAP group was significantly higher than that in SABP group and SAAP group(P < 0.05),and the prevalence of fatty liver in SAAP group was significantly higher than that in SABP group(P<0.05).3.TG in HL-SAP group was significantly higher than that in SABP group and SAAP group(P<0.05);HDL-C in HL-SAP group was significantly lower than that in SABP group and SAAP group(P<0.05).There was no significant difference in LDL-C among the three groups(P<0.05).4.There were no significant differences in white blood cells and D-dimer between the three groups(P>0.05);The C-reactive protein in HL-SAP group was significantly higher than that in SABP group(P<0.05),and the serum calcium in HL-SAP group was significantly lower than that in SABP group(P>0.05).5.The TBIL and DBIL values in SABP group were significantly higher than those in HL-SAP group and SAAP group(P<0.05);ALT and AST values in SABP group were significantly higher than those in HL-SAP group and SAAP group(P<0.05).6.The blood glucose in HL-SAP group was significantly higher than that in SABP group and SAAP group(P<0.05),and there was no significant difference in serum creatinine between the three groups(P>0.05).7.There were no significant differences in the incidence of APFC,ANC,PP,WON,peritoneal effusion,pleural effusion,respiratory failure,circulatory failure,renal failure and MODS between the three groups(P>0.05).The incidence of acute liver injury in SABP group was significantly higher than that in HL-SAP group and SAAP group(P<0.05).The incidence of SIRS in HL-SAP patients was significantly higher than that in SABP patients(P<0.05).8.The proportion of CTSI score≥7 in HL-SAP group was significantly higher than that in SABP group(P<0.05);The recurrence rate of SABP group was significantly lower than that of HL-SAP group and SAAP group(P<0.05).There was no significant difference in mortality between the three groups(P>0.05).Conclusions: 1.SABP is more common in elderly female patients,while HL-SAP and SAAP are more common in young male patients.HL-SAP patients are mainly characterized by high BMI,and HL-SAP patients are more prone to lipid metabolism disorders,requiring timely lipid-lowering therapy;2.SABP patients are more prone to liver function injury than other etiology patients,and HL-SAP patients are more prone to diabetes than SABP patients.HL-SAP patients have the highest incidence of fatty liver,followed by SAAP patients.Patients with diabetes and fatty liver should strictly control glucose and blood lipids to reduce the risk of HL-SAP;3.The etiology of SAP was not related to mortality and the formation of local complications,HL-SAP patients were more likely to develop SIRS than SABP patients;4.The severity of HL-SAP is higher than SABP,HL-SAP patients and SAAP patients were more prone to relapse.Therefore,such patients should avoid high-fat diet and alcohol abuse to reduce the risk of recurrence after recovery.