Clinical Characteristics Of AP In The Yan’an University Affiliated Hospital And Analysis Of Risk Factors For Progression To Severe AP

Objective:This study summarized the clinical characteristics of patients with acute pancreatitis（AP）in Yan’an University Affiliated Hospital,and analyzed the risk factors for the progression of AP to severe AP,identified severe AP in time and intervened to prevent disease progression.Methods:Patients with AP from 2019.1.1 to 2021.12.31 in Yan’an University affiliated Hospital were included in this study,excluding patients who are pregnant or under 18 years old,patients with previous pancreatic diseases,chronic liver and kidney diseases,malignant tumor and loss of key indicators were excluded.Basic data and laboratory indicators of AP patients were collected to analyze their overall clinical characteristics according the different groups of gender,etiology,age,BMI,RAC classification.According to the RAC grading standard,the patients with AP were divided into two groups:MAP as mild group,MSAP and SAP as severe group.Logistic regression analysis was used to explore the high risk factors of severe AP.Results:1.In this study,401 patients were included,66.3%were males;49.1%were between18 and 44 years old;52.9%famales’age were higher than 45;ABP group were48.1%,HTGP group was 24.9%;BMI between 24 and 27.9kg/m² accounted for42.6%,males’BMI higher than 28kg/m²were 85.5%;patients with fatty liver disease accounted for 52.9%;MAP group was 69.6%in RAC grades.2.1 After grouping and comparing the gender of patients with AP,it was found that men with a history of hypertension,diabetes,fatty liver,smoking,drinking and overweight accounted for a large proportion,with higher ALB,TG,TC,CRE,UA and lower age,NLR,PLR,LPS,AMY,Ca²⁺,ALT,ALP and HDL-C（P<0.05）.2.2 After grouping and comparing the patients with AP by age,it was found the number of males,patients with history of diabetes,drinking,smoking,fatty liver and obesity accounted for a large proportion of patients aged 18 to 44,with higher levels of ALB,Ca²⁺,TG,TC,CRE and UA,more common in patients with history of hypertension and ABP over 45 years old,and higher in NLR,PLR,LPS,AMY,ALT,TBi L,ALP and HDL-C（P<0.017）.2.3 After grouping and comparing the patients with AP according to their etiology,it was found that there were more patients with higher age and BMI<24kg/m² in ABP group,and higher levels of NLR,PLR,LPS,AMY,ALT,TBi L,TBA,GGT and ALP.The number of males,with a history of diabetes,drinking,smoking,moderate to severe fatty liver accounted for a higher proportion in HTGP and AAP groups,and higher levels of TC,TG and UA（P<0.008）.2.4 After grouping and comparing the patients with AP according to BMI,it was found that the older age and ABP were more common in the BMI<18.5kg/m² group,and the ALB was lower;while the younger age,HTGP,history of diabetes,fatty liver,drinking and smoking accounted for a large proportion in the BMI≥28kg/m² group,with higher FBG,CRE,UA,TG,TC and lower AMY,ALT,ALP and HDL-C（P<0.008）.2.5 Comparing the patients with different RAC grades,it was found that patients with fatty liver accounted for a minority in MAP group,shorter hospital stay,higher TC and LDL-C,lower NLR,CRP and BUN;patients with lower ALB and Ca²⁺,higher CRE in SAP group.In AP patients,the proportion of BISAP score≥3 and MCTSI score≥4will increase with the aggravation of the disease（P<0.017）.3.According to RAC grading standard,patients with AP were divided into two groups:MAP as mild group,MSAP and SAP as severe group.The results of univariate analysis showed that old age,fatty liver,BISAP score≥3,MCTSI score≥4,WBC,NLR,CRP,TBil,CRE,BUN and FBG were risk factors for progression to severe AP,while ALB,Ca²⁺and TC were protective factors.The results of multivariate analysis showed that lower ALB,higher CRE,fatty liver,BISAP score≥3 and MCTSI score≥4 were independent risk factors for the progression of AP to severe AP.Conclusion:1.The main cause of AP is biliary disease,ABP is common in middle-aged and elderly women,HTGP is mostly in young obese men;RAC grade is mainly MAP,elderly patients with low weight should be vigilant against the occurrence of SAP.2.Logistic regression analysis showed that lower ALB,higher CRE,fatty liver disease,BISAP score≥3 and MCTSI score≥4 were high risk factors for the progression of AP to severe AP.