【摘要】 目的探讨血液灌流(hemoperfusion,HP)及双重滤过血浆置换(double-filtration plasmapheresis,DFPP)对高脂性重型急性胰腺炎血脂的疗效影响。方法对在2016年01月~2018年04月确诊为高脂性重型急性胰腺炎的50例患者随机分为HP及DFPP,分析其治疗效果,对其并发症、腹部进展情况、死亡人数(率)、单次费用、单次平均下降百分数及血脂下降疗效的分析。结果 HP组及DFPP组患者性别、年龄、体质量指数(body mass index,BMI)、入院时急性生理与慢性健康评分(acute physiology,age,chronic health evaluation II,APACHEⅡ评分)及入院时血脂水平无统计学差异。2组并发症、腹部CT进展情况及死亡人数进行比较,无统计学差异。单次费用DFPP较HP高,单次平均血浆三酰甘油及总胆固醇下降百分数HP组分别为60.1%,37.0%,DFPP组分别为63.2%,41.8%。HP组灌流前后血浆三酰甘油[(47.08±35.8)mmol/L比(17.49±20.37)mmol/L,t=4.124,P=0.001]、总胆固醇水平[(13.52±5.90)mmol/L及(10.01±6.11)mmol/L,t=5.737,P=0.000]有显著差异。DFPP组血浆置换前后血浆三酰甘油[(44.42±42.30)mmol/L比(16.31±17.68)mmol/L,t=3.298,P=0.011]、总胆固醇水平[(18.29±16.13)mmol/L比(9.73±7.17)mmol/L,t=2.656,P=0.029]有显著差异。HP组与DFPP组TG下降程度无显著差异[(18.55±21.99)mmol/L比(16.31±17.68)mmol/L,t=0.207,P=0.084],2组血浆总胆固醇下降程度亦无统计学差异[(10.78±6.27)mmol/L比(9.37±7.17)mmol/L,t=0.272,P=0.792]。结论 HP及DFPP均不同程度的减低三酰甘油及总胆固醇水平,HP及DFPP对其血脂水平的降低效果相当。更多还原

【Abstract】 Objective To investigate the effect of hemoperfusion and double-filtration plasmapheresis for the treatment of hyperlipidemia in severe acute pancreatitis patients. Methods Fifty patients diagnosed as severe acute pancreatitis with hyperlipidemia between January 2016 and April 2018 were randomly divided into hemoperfusion(HP) group and double-filtration plasmapheresis(DFPP) group. Results HP group and DFPP group were comparable in terms of gender, age, body mass index(BMI), acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score and blood lipid levels at admission. There were also no statistical differences in complications, changes of abdominal CT images, and number of death between the two groups.The medical expense of DFPP was higher than that of HP. The mean decrease percentages of plasma triglyceride(TG) and total cholesterol(TC) after one treatment were 60.1% and 37.0%, respectively, in HP group and were 63.2% and 41.8%, respectively, in DFPP group. In HP group before and after the treatment, plasma TG levels were(47.08 ± 35.8)mmol/L and 17.49 ± 20.37 mmol/L, respectively(t=4.124, P=0.001), and TC levels were(13.52 ± 5.90)mmol/L and 10.01 ± 6.11 mmol/L, respectively(t=5.737, P=0.000). In DFPP group before and after the treatment, plasma TG levels were(44.42±42.30)mmol/L and(16.31±17.68)mmol/L, respectively(t=3.298, P=0.011), and TC levels were(18.29 ± 16.13) mmol/L, and(9.73 ± 7.17)mmol/L, respectively(t=2.656, P=0.029). There were no differences in the decrease of TG [(18.55 ± 21.99)mmol/L in HP group and(16.31 ± 17.68)mmol/L in DFPP group, t=0.207 P=0.084] and TC [(10.78 ± 6.27)mmol/L in HP group and(9.37±7.17)mmol/L in DFPP group, t=0.272 P=0.792] between the two groups. Conclusions Both HP and DFPP reduced TG and TC levels. Moreover, HP and DFPP had comparable effects on lowering blood lipid levels.更多还原