發(fā)布時(shí)間：2018-03-01 01:24

  本文關(guān)鍵詞： 急性胰腺炎 非酒精性脂肪性肝病 嚴(yán)重程度 回顧性分析 危險(xiǎn)因素　出處：《西安醫(yī)學(xué)院》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的通過對(duì)急性胰腺炎患者的資料進(jìn)行回顧性分析,評(píng)估非酒精性脂肪性肝病與急性胰腺炎嚴(yán)重程度之間的關(guān)系,為急性胰腺炎的診斷、治療、預(yù)防及預(yù)后研究提供科學(xué)依據(jù)。方法收集2013年6月-2016年9月在西安醫(yī)學(xué)院第一附屬醫(yī)院診斷為急性胰腺炎的637例住院患者資料,根據(jù)診斷及排除標(biāo)準(zhǔn)最終納入251例,其中男性144例(57.4%),女性107例(42.6%),年齡14-88歲,平均(45.37±15.46)歲。應(yīng)用SPSS22.0軟件對(duì)所有數(shù)據(jù)進(jìn)行整理分析。兩樣本間的計(jì)量資料比較應(yīng)用Mann-Whitney U檢驗(yàn)(非正態(tài)分布)或t檢驗(yàn)(正態(tài)分布),計(jì)數(shù)資料的兩樣本間比較應(yīng)用χ2檢驗(yàn),多樣本間的比較采用非參數(shù)檢驗(yàn)中的二個(gè)獨(dú)立樣本檢驗(yàn);危險(xiǎn)因素分析采用logistic回歸分析,P0.05為有統(tǒng)計(jì)學(xué)意義。圖表應(yīng)用Excel2003及GraphPad Prism 6.0軟件制作。結(jié)果1.合并非酒精性脂肪性肝病的患者,其急性胰腺炎的嚴(yán)重程度與不合并非酒精性脂肪性肝病的急性胰腺炎患者有差異,差異有統(tǒng)計(jì)學(xué)意義(χ2=11.004,P=0.001),非酒精性脂肪性肝病的嚴(yán)重程度對(duì)急性胰腺炎的嚴(yán)重程度有影響,差異有統(tǒng)計(jì)學(xué)意義(χ2=7.444,P=0.024)。非酒精性脂肪性肝病(95%CI:1.261-2.878,OR=2.478,P=0.017)、白細(xì)胞計(jì)數(shù)(95%CI:1.747-7.043,OR=3.508,P=0.000)、淀粉酶水平(95%CI:1.148-3.868,OR=2.107,P=0.016)與急性胰腺炎嚴(yán)重程度間存在相關(guān)性(似然比檢驗(yàn)卡方=34.696,P0.001,模型有統(tǒng)計(jì)學(xué)意義)。2.體重指數(shù)和急性胰腺炎的嚴(yán)重程度間有差異,差異有統(tǒng)計(jì)學(xué)意義(χ2=13.082,P=0.004)。伴有肥胖的患者,其急性胰腺炎的嚴(yán)重程度與不伴有肥胖的急性胰腺炎患者間有統(tǒng)計(jì)學(xué)差異(χ2=9.092,P=0.003)。3.合并有非酒精性脂肪性肝病的急性胰腺炎患者,體重指數(shù)和甘油三酯有正相關(guān)性(r=0.360,P=0.000),體重指數(shù)與空腹血糖、甘油三酯與空腹血糖間均無相關(guān)性(P0.05)。結(jié)論1.非酒精性脂肪性肝病與急性胰腺炎的嚴(yán)重程度相關(guān);且非酒精性脂肪性肝病的嚴(yán)重程度對(duì)急性胰腺炎的嚴(yán)重程度有影響;2.非酒精性脂肪性肝病、白細(xì)胞計(jì)數(shù)、血淀粉酶水平是影響急性胰腺炎嚴(yán)重程度的危險(xiǎn)因素;3.體重指數(shù)是反映急性胰腺炎嚴(yán)重程度的指標(biāo)。
[Abstract]:Objective to evaluate the relationship between non-alcoholic fatty liver disease and the severity of acute pancreatitis by retrospective analysis of the data of patients with acute pancreatitis, and to evaluate the diagnosis and treatment of acute pancreatitis. Methods from June 2013 to September 2016, 637 cases of acute pancreatitis diagnosed in the first affiliated Hospital of Xi'an Medical College were collected, and 251 cases were included according to the criteria of diagnosis and exclusion. Among them, 144 males (57.4%) and 107 females (42.6%), aged 14-88, The average age was 45.37 鹵15.46 years old. All the data were analyzed by SPSS22.0 software. The comparison between the two samples was made by Mann-Whitney U test (non-normal distribution) or t test (normal distribution), and 蠂 2 test was used to compare the two samples of counting data. Two independent samples of non-parametric test were used to compare the multi-samples. The risk factors were analyzed by logistic regression analysis (P0.05). The chart was made with Excel2003 and GraphPad Prism 6.0 software. Results 1. The patients with non-alcoholic fatty liver disease, The severity of acute pancreatitis was significantly different from that of non-alcoholic fatty liver disease (蠂 ~ 2, 11.004, P < 0.001). The severity of non-alcoholic fatty liver disease had an effect on the severity of acute pancreatitis. The difference was statistically significant (蠂 2 / 7.444 / P 0.024). There was a correlation between 95CI: 1.261-2.878 / P 0.017, a white blood cell count of 95CIW 1.747-7.043OR3.508P0.000, amylase level 95CI1.148-3.868 / 107P0.016) and the severity of acute pancreatitis (the likelihood ratio was 34.696P _ 1), the model had statistical significance. There are differences in the severity of acute pancreatitis, The severity of acute pancreatitis in patients with obesity was significantly different from that in patients without obesity (蠂 2 9.092 P 0.003. 3). Patients with acute pancreatitis with non-alcoholic fatty liver disease were found to have a significant difference in the severity of acute pancreatitis (蠂 29.092P 0.003. 3), and there was a significant difference in the severity of acute pancreatitis between the patients with obesity and those without obesity (蠂 29.092P 0.003. 3). There was a positive correlation between BMI and triglyceride. There was no correlation between BMI and fasting blood glucose, triglyceride and fasting blood glucose. Conclusion 1. Non-alcoholic fatty liver disease is related to the severity of acute pancreatitis. The severity of non-alcoholic fatty liver disease has an effect on the severity of acute pancreatitis 2.The white blood cell count of non-alcoholic fatty liver disease, Serum amylase level is a risk factor affecting the severity of acute pancreatitis. Body mass index (BMI) is an index to reflect the severity of acute pancreatitis.
【學(xué)位授予單位】：西安醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R575;R576

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