Comparative Study On Clinical Features Between Moderate Severe Hypertriglyceridemia-induced Pancreatitis And Severe Hypertriglyceridemia-induced Pancreatitis

OBJECTIVE:To investigate the difference of clinical features between moderate severe hypertriglyceridemia-induced pancreatitis(HLMSAP)and severe hypertriglyceridemia-induced pancreatitis(HLSAP),and to provide evidence for early clinical recognition and intervention.METHODS:This study retrospectively analyzed 43 cases of HLMSAP and 28 cases of HLSAP admitted to our hospital from January 2019 to December 2020,which included 48 males and 23 females with the age ranged from 25 to 67 years old.Among them,patients diagnosed with HLSAP were in the severe group(HLSAP group),and patients diagnosed with HLMSAP were in the moderate severe group(HLMSAP group).Comparisons were carried out based on baseline data,clinical signs,laboratory tests,evaluation systems and prognostic indicators.SPSS 20.0 software was used for statistical analysis.Counting data were expressed as percentages,and measurement data were expressed as mean ± standard deviation or median(minimum～maximum)according to whether they were in line with normal distribution.Chi-square test was used for comparison of counting data between groups,and two independent samples T-test was used for comparison of measurement data between groups.P<0.05 indicated statistically difference.RESULTS:There were no significant differences between the two groups in gender,history of alcoholism and smoking,history of hypertension and diabetes,but the patients in HLSAP group were older(P=0.024),with higher BMI(P=0.038),and had a higher incidence of fatty liver(P=0.040).After early admission,there were no significant differences in mean arterial pressure,heart rate and respiratory rate between the two groups,but the blood oxygen saturation in the HLSAP group was significantly lower than that in the HLMSAP group(P=0.019),and the proportion of patients with disturbance of consciousness was also higher(P=0.013).There was no statistical difference in the characters containing Hb,RDW,PLT,PT,INR,AMS,LMS,ALT,AST,Glu,and TC between the two groups.However,the characters of WBC,CRP,ALB,Cr,BUN,TG,LDL,and K+in HLSAP group were higher than those in HLMSAP group with a significant difference(P<0.05),whereas the characters of HDL,Na+,and Ca2+ in HLSAP group were significantly lower than those in HLMSAP group.The difference was statistically significant(P<0.05).The scores of APACHEII,Ranson,AGI and CTSI in HLSAP were higher than those of HLMSAP group,and the results were statistically different(P<0.05).Moreover,the results showed that patients in HLSAP group had a higher incidence of pleural effusion,peritoneal effusion,peripancreatic fluid accumulation,pancreatic necrosis,peripancreatic infection,ARDS,acute liver injury,acute kidney injury,longer hospital stay,and mortality than those in HLSAP group,with a statistical significance of P<0.05.CONCLUSION:Patients with HLMSAP and HLSAP have great differences in general data,clinical signs,laboratory examination,clinical evaluation system,complications,and prognostic indicators.Identification of these differences can help early clinical intervention and improve prognosis.