Patterns of change in triglyceride during the clinical course of acute pancreatitis / 中华胰腺病杂志

ABSTRACT

Objective To investigate the patterns of change in serum triglyceride (TG) during the clinical course of acute pancreatitis (AP) and its clinical relevance.Methods Eighty one consecutive cases of AP were retrospectively reviewed.Based on their TG levels on admission,the patients were divided into high TG group (TG ≥ 11.3 mmol/L),median TG group (5.65 ≤ TG ＜ 11.3 mmol/L) and low TG group (TG ＜ 5.65 mmoL/L).They were additionally categorized into different treatment groups depending upon whether they received hemopurification,lipid lowering drugs or fat emulsions parenteral nutrition,and no special treatment group.The clinical characteristics and the patterns of change in TG were analyzed.Results The mean age of high,median,low TG group was (40 ± 10),(40 ±8),(51 ± 13) years old,and the difference among the high,median TG group and low TG group was statistically significant (P ＜ 0.01),but there was no significant difference between high and median TG group.In terms of sex,history of diabetes,hypertension,hypertriglyceridemia,acute pancreatitis,smoking and drinking,predisposing factors,disease onset season,severity of AP and hospitalization length,there was no significant difference among the 3 groups.Within the first 48h of admission,the TG levels of high and median TG group decreased significantly,and the percent of decline was (33.77 ± 26.57) ％,(43.46 ± 17.76) ％ in the first day,and it was (66.33 ± 17.20) ％,(57.50 ± 2.70) ％ in the second day,then it gradually decreased,but maintained a slightly higher level than normal.In contrast,no trend of decrease in TG during hospitalization was observed in low TG group.The patterns of change in TG in patients receiving hemopurification or lipid-lowering drugs were similar to those without special treatment.Fat emulsions parenteral nutrition exerted no significant influence on TG level in patients of low TG in no special treatment group.Of the patients without special treatment,the TG and total serum cholesterol level was positively correlated,while there was no correlation with other parameters.Conclusions The patterns of change in TG during the clinical course of AP vary with the patients' TG level on admission.If the decrease of TG does not reach 1/3 with routine treatment within the first 48 h,hemopurification therapy may be considered;for patients with TG ＜ 5.65 mmol/L,fat emulsions parenteral nutrition treatment can be accepted.