70 岁以上老年急性胰腺炎患者的临床特征分析

Analysis of clinical features of acute pancreatitis in patients aged 70 years and older

摘要:

目的 探讨≥ 70 岁老年急性胰腺炎（AP）患者的临床特征。方法 选取2013 年6 月—2018 年3 月 于西南医科大学附属医院住院的342 例≥ 70 岁老年AP 患者的病历资料作为实验组，随机选择同期年龄 15 ～ 59 岁的AP 患者684 例作为对照组，分析两组患者的病历资料。结果 两组男女比例、性别比较，差异 有统计学意义（P <0.05）。实验组的首位病因为胆道疾病（54.97%），对照组的首位病因为高脂血症（44.01%）。 实验组血淀粉酶、谷丙转氨酶、谷草转氨酶、直接胆红素及肌酐水平高于对照组（P <0.05），血钙、总胆固 醇、甘油三酯、白蛋白水平低于对照组（P <0.05）。实验组合并高血压、冠状动脉粥样硬化性心脏病比例高 于对照组（P <0.05）。相比对照组，实验组更易发生呼吸衰竭、肾衰竭、胆道感染及肺部感染（P <0.05）。实 验组总病死率及重症急性胰腺炎病死率高于对照组（P <0.05）。结论 年龄≥ 70 岁老年AP 患者女性比例较高， 主要病因为胆道疾病，其并发症发生率及病死率高，了解其临床特征有助于制定有针对性的诊疗方案。

Abstract:

Objective To assess the clinical features of acute pancreatitis (AP) in patients aged 70 years and older. Methods Clinical data of 342 patients aged 70 years and older (group A) who diagnosed AP in our hospital from June 2013 to March 2018 were retrospectively analyzed. And 684 patients of AP aged 15 to 59 (group B) were randomly selected as the control group during the same period. Results ① The ratio of male to female was 1: 1.55 in group A, so the composition with group B (1.79: 1) was significant different from group A (P < 0.05). ② The first etiological cause of group A was biliary disease (54.97%) and that of group B was hyperlipemia (44.01%), and there was statistically difference between the two groups (P < 0.05). ③ The average levels of amylase, ALT, AST, direct bilirubin and creatinine in group A were higher than those in group B, while the average levels of serum calcium, total cholesterol, triglycerides and albumin were lower than those in group B (P < 0.05). ④ The prevalence of hypertension and coronary heart disease in group A was higher than that in group B (P < 0.05). Compared with group B, group A was more prone to encounter respiratory failure, renal failure, biliary tract infection and pulmonary infection, which makes statistically sense between the two groups (P < 0.05). ⑤ The total mortality and SAP mortality rates of group A were higher than those of group B, which makes significant difference between the two groups (P < 0.05). Conclusions Women make up a higher proportion of patients aged 70 years and older who diagnosed AP.The main cause of senile AP is biliary disease. And senile AP has more complications and higher mortality rate. We should attach great importance to understanding its clinical features to propose targeted diagnosis and treatment plans.