【摘要】：目的:探討不同分型急性胰腺炎患者維生素A、B1、B2、B6、B9、B12、C、D、E的濃度變化,分析發(fā)病過程中血清維生素濃度變化的相關(guān)影響因素。方法:本研究收集111例急性胰腺炎患者作為病例組,根據(jù)患者病情輕重將其分為三組:輕癥(MAP)組(39例)、中重癥(MSAP)組(38例)、重癥(SAP)組(34例),同時隨機(jī)選取37例健康志愿者為對照組。在靜脈給予常規(guī)推薦劑量維生素的情況下,檢測急性胰腺炎患者血清維生素A、B1、B2、B6、B9、B12、C、D、E的濃度、血淀粉酶、電解質(zhì)、肝腎功、PCT、CRP等血液指標(biāo),并計算急性胰腺炎患者床旁嚴(yán)重度指數(shù)(BISAP)評分,比較不同分型急性胰腺炎患者多種維生素的濃度差異,利用單因素分析及多元逐步回歸分析的方法,分析影響急性胰腺炎患者血清維生素濃度變化的諸多相關(guān)影響因素。結(jié)果:(1)急性胰腺炎患者血清維生素B1、B2、B6、B9、B12的濃度與健康對照組相比,濃度出現(xiàn)下降趨勢,但差別無統(tǒng)計學(xué)意義(P0.05)。(2)急性胰腺炎患者血清維生素A、C、D、E濃度均低于健康對照組,差別有統(tǒng)計學(xué)意義(P0.05)。其中,SAP組較MAP組維生素A濃度下降,差別有統(tǒng)計學(xué)意義(P0.01);MAP組、SMAP組與SAP組相比,維生素C、D、E濃度明顯下降,差別均有統(tǒng)計學(xué)意義(P0.01)。(3)單因素分析中,急性胰腺炎患者血清維生素C濃度與年齡呈負(fù)相關(guān)(r=-0.294,P=0.002),隨著年齡的增加,維生素C濃度隨之降低,而血清維生素A、D、E濃度變化與患者年齡因素?zé)o明顯相關(guān)性。抽血前禁食天數(shù)7天的急性胰腺炎患者維生素C濃度顯著低于≤7天組,差異有統(tǒng)計學(xué)意義,而維生素A、D、E濃度無差異。另外,急性胰腺炎患者血清維生素A、C、D、E濃度與性別、BMI無相關(guān)性(P0.05)。(4)通過多元逐步回歸分析發(fā)現(xiàn)急性胰腺炎患者血清維生素A、C、D、E濃度與患者性別、身高、體重、體質(zhì)指數(shù)、血清白蛋白、白細(xì)胞、血紅蛋白、CRP、PCT、住院天數(shù)均無關(guān),與BISAP評分有關(guān),BISAP評分越高,血清維生素A、C、D、E濃度變化越明顯;其中維生素C濃度變化還與抽血前禁食天數(shù)、年齡有關(guān)。維生素A濃度與BISAP評分的回歸方程為y=0.589-0.04x;維生素D濃度與BISAP評分的回歸方程為y=76.634-14.917x;維生素E濃度與BISAP評分的回歸方程為y=12.16-7.28x;維生素C濃度與BISAP評分(x1)、抽血前禁食天數(shù)(x2)、年齡(x3)的回歸方程為y=40.019-1.852x1-0.447x2-0.052x3。結(jié)論:(1)不同分型急性胰腺炎患者血清維生素A、C、D、E濃度存在統(tǒng)計學(xué)差異;(2)急性胰腺炎患者血清維生素A、C、D、E濃度與病情嚴(yán)重程度有關(guān),病情越嚴(yán)重,血清維生素A、C、D、E濃度下降越顯著;(3)維生素C濃度變化與抽血前禁食天數(shù)及年齡相關(guān)。(4)重癥急性胰腺炎患者靜脈補(bǔ)充常規(guī)推薦量的維生素A、C、D、E不能滿足發(fā)病時機(jī)體需要量。
[Abstract]:Objective: to investigate the changes of vitamin A, B _ 1 B _ 2 B _ (2) B _ (6) B _ (9) B _ (12) C _ (1) C _ (C) E in patients with acute pancreatitis of different types and to analyze the related factors influencing the changes of serum vitamin concentration during the onset of acute pancreatitis. Methods: 111 patients with acute pancreatitis were divided into three groups according to the severity of the disease: mild (MAP) group (39 cases), moderate and severe (MSAP) group (38 cases), severe (SAP) group (34 cases). At the same time, 37 healthy volunteers were randomly selected as control group. The concentration of serum vitamin A, B1OB2OB6OB9B9B12, serum amylase, electrolytes, liver and kidney function, PCT,CRP and so on in patients with acute pancreatitis were detected by intravenous administration of routine recommended doses of vitamins. The bedside severity index (BISAP) score of acute pancreatitis patients was calculated, and the multivitamin concentrations in patients with acute pancreatitis were compared by single factor analysis and multivariate stepwise regression analysis. To analyze the influence factors of serum vitamin concentration in patients with acute pancreatitis. Results: (1) the concentration of serum vitamin B1, B2B6, B9, B12 in patients with acute pancreatitis showed a downward trend compared with the healthy control group. But there was no significant difference (P0.05). (2) in acute pancreatitis patients with serum vitamin A,). (E concentrations were lower than the healthy control group, the difference was statistically significant (P0.05). The concentration of vitamin A in SAP group was significantly lower than that in MAP group (P0.01). In MAP group, SMAP group and SAP group, the concentration of vitamin C and DIAE decreased significantly, and the difference was statistically significant (P0.01). (3) in univariate analysis. There was a negative correlation between serum vitamin C concentration and age in patients with acute pancreatitis (r = 0.294P0. 002). With the increase of age, vitamin C concentration decreased, while serum vitamin A, D, There was no significant correlation between E concentration and age factors. The concentration of vitamin C in the patients with acute pancreatitis was significantly lower than that in the group of 鈮，

本文編號：2311347