本文選題：脂肪胰 + 急性胰腺炎　； 參考：《浙江大學(xué)》2017年碩士論文

【摘要】：背景與目的:隨著肥胖與代謝綜合征患者的增加,與其密切相關(guān)的脂肪胰也引起了研究者的注意。脂肪胰(Nonalcoholic fatty pancreas disease,NAFPD)是一種普遍但常常被臨床醫(yī)生忽視的疾病,已有研究表明它與代謝綜合征、糖尿病、急慢性胰腺炎、胰腺癌等均密切相關(guān)。急性胰腺炎是常見的急腹癥,重癥胰腺炎常因并發(fā)器官衰竭而預(yù)后不佳。本研究的目的為探究脂肪胰與急性胰腺炎嚴(yán)重程度的關(guān)系。方法:選取于2014.1.1至2016.12.31期間至浙江大學(xué)附屬第一醫(yī)院急診或住院的急性胰腺炎病人,并且在入院后48h內(nèi)行腹部計(jì)算機(jī)斷層掃描(CT)增強(qiáng)檢查,發(fā)病前1年內(nèi)行腹部CT檢查。測(cè)量研究對(duì)象胰腺CT值、脾臟CT值、內(nèi)臟脂肪組織(Visceral adipose tissue,VAT),計(jì)算其體重指數(shù)(Body mass index,BMI),評(píng)估其發(fā)病后Ranson's評(píng)分、APACHE Ⅱ(急性生理功能和慢性健康狀況評(píng)分表Ⅱ)評(píng)分、MCTSI(修正CT嚴(yán)重指數(shù))評(píng)分。比較胰腺CT值與脾臟CT值之差與之比(P-SP/S)、VAT、BMI與上述評(píng)分的關(guān)系。結(jié)果:入組30例患者中,男性占56.7%(17/30),女性占43.3%(13/30),平均年齡57.73±16.6歲。輕癥胰腺炎患者占60%(18/30);重癥胰腺炎患者占40%(12/30)。重癥胰腺炎患者胰腺CT平均值、P-S、P/S顯著低于輕癥胰腺炎患者。并且胰腺CT平均值、P-S、P/S均與Ranson's評(píng)分、APACHEⅡ評(píng)分、MCTSI評(píng)分顯著相關(guān)。脂肪胰組重癥胰腺炎患者比率明顯高于非脂肪胰組。重癥胰腺炎患者內(nèi)臟脂肪組織顯著高于輕癥胰腺炎患者,重癥胰腺炎與輕癥胰腺炎患者BMI無顯著性差異。結(jié)論:脂肪胰與急性胰腺炎嚴(yán)重程度相關(guān),并且P-S、P/S與急性胰腺炎嚴(yán)重程度成負(fù)相關(guān)。內(nèi)臟脂肪組織與急性胰腺炎嚴(yán)重程度相關(guān)。脂肪胰及高內(nèi)臟脂肪組織患者更易發(fā)展為重癥胰腺炎,因此,兩者在早期評(píng)估急性胰腺炎預(yù)后中均有重要作用。
[Abstract]:Background & objective: with the increase of obesity and metabolic syndrome, fatty pancreas, which is closely related to obesity and metabolic syndrome, has also attracted the attention of researchers. Nonalcoholic fatty pancreas disease (NAFPDD) is a common disease that is often neglected by clinicians. It has been shown to be closely related to metabolic syndrome, diabetes mellitus, acute and chronic pancreatitis, pancreatic cancer and so on. Acute pancreatitis is a common acute abdomen, severe pancreatitis is often associated with organ failure and poor prognosis. The aim of this study was to explore the relationship between fatty pancreas and severity of acute pancreatitis. Methods: patients with acute pancreatitis were selected from the first affiliated Hospital of Zhejiang University from January 1 to December 31, 2014.The patients were examined by CT within 48 hours after admission, and abdominal CT was performed within 1 year before the onset of the disease. The CT values of pancreas and spleen were measured. Visceral adipose tissue was collected from visceral adipose tissue of visceral adipose tissue. The body mass index (BMI) was calculated, and the Ranson's score and Apache 鈪，

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