ĐIỂM LÂM SÀNG VÀ CẬN LÂM SÀNG Ở BỆNH NHÂN VIÊM TỤY CẤP DO TĂNG TRIGLYCERIDE THEO PHÂN ĐỘ TĂNG TRIGLYCERIDE CỦA HỘI NỘI TIẾT 2010

Abstract

Backgrounds: Hypertriglyceridemia induced acute pancreatitis (HTGP) was associated with increased risk of local complications, recurrent acute panpcreatitis, the frequence of other complications and high mortality as compared to other causes. Determining factors associated with the severity of hypertriglyceridemia (HTG) in patients with HTGP was necessary and important in management of patients with acute pancreatitis. Oblective: To assess the relationship between clinical, subclinical factors and outcomes in patients with hypertriglyceridemia induced acute pancreatitis (HTGP) with the severity of hypertriglyceridemia (HTG) by the 2010 endocrine society. Methods: We prospectively analyzed a total of 132 patients with HTGP from January 2017 to May 2019 at Cho Ray Hospital. HTGP patients were divided into two groups according to the grades of hypertriglyceridemia (HTG) by Endocrine Society [4]: very severe HTG (³2000 mg/dL) and severe HTG (1000 – 1999 mg/dL). Serum TG levels measured within 48 hours of admission. We analyzed the differences between two groups of patients, including general infomation, clinical characteristics, biochemical data and outcomes. Results: Comparing with the severe HTG group, patients with the very svere HTG had significantly higher level of hemoglobin (Hb) (p=0.017), lower levels of  prothrombin time (PT) (p=0.001) and creatinine (p=0.011). The prevalence of dyslipidemia was significantly high in the very svere HTG group (p=0.022). Multivariate analysis demonstrated that history of hypertension, levels of C-reactive protein at 48 hours post-hospitalization (CRP48), and levels of Hb and PT were statistically significant relating with the very severe HTG (p<0.05). Conclusions: In patients with HTGP, there were significantly higher of Hb and lower of PT, creatinine in patients with the very severe HTG as compared to the severe HTG. The very severity of HTG was significantly associated with history of dyslipidemia. According to the multivariate analysis, history of hypertension, levels of CRP48 and levels of Hb and PT were significant related to the very severe HTG (p<0.05). Hypertriglyceridemia induced acute pancreatitis has a clinical presentation similar to that of general acute pancreatitis.