Aralik 2017
Hipertrigliseridemi iliskili akut pankreatit hastalarinin degerlendirilmesi
Evaluation of hypertriglyceridemia-induced acute pancreatitis
- Ana Sayfa
- Sayılar
- Aralik 2017
- Hipertrigliseridemi iliskili akut pankreatit hastalarinin degerlendirilmesi ...
Özet
Giris ve Amaç: Hipertrigliseridemi, akut pankreatitin en yaygin üçüncüsebebidir. Bu çalismanin amaci, hipertrigliseridemi iliskili akut pankreatittanisi konulan hastalarin karakteristiklerini, tekrar ortaya çikma sikligive mortalitesini arastirmaktir. Gereç ve Yöntem: Ocak 2010 - Agustos2017 tarihleri arasinda siddetli hipertrigliseridemi iliskili akut pankreatit tanisi ile kurumumuzda 24 hasta (yas ortalamasi:38,8±6,5 yil, %79erkek) tedavi edildi. Siddetli hipertrigliseridemi iliskili akut pankreatitidegerlendirmek için açlik lipid profili, amilaz, lipaz degerleri ve hastademografik verileri kaydedildi. Bulgular: Çalisma periyodu sirasindakurumumuza akut pankreatit tanisi ile 615 hasta kabul edildi. Siddetlihipertrigliseridemi iliskili akut pankreatiti olan hasta sayisi 24 (%3,9) idi.Tüm hastalarda, medikal tedavi sonrasi [standart tedavi ile terapötikplazma aferezi (20 hasta) veya sadece standart tedavi (4 hasta)] trigliserid düzeylerinde anlamli iyilesme oldu. Bizim hastalarin hipertrigliseridemi ile iliskili olarak bilinen durumlardan, %41,6’sinda diyabetesmellitus, %16,6’sinda bozulmus glukoz toleransi, %25’inde asiri alkolalimi, %8,3’ünde hamilelik vardi. Hastane mortalitesi %4,1, rekürrenpankreatit ise %29 idi. Sonuç: Rekürren pankreatit orani yüksek saptandi. Bu, düzensiz fibrat kullanimi, diyet uyumumun zayif olmasi, kötükan sekeri regülasyonu, hamilelik ile iliskili olabilir. Mortalite orani %4,1idi. Bu kismen bizim multidisipliner takim çalismasi sayesinde, serumtrigliserid düzeyinin agresif düzeltilmesinden dolayi olabilir. Siddetli hipertrigliseridemi iliskili akut pankreatit hizlica tedavi edilmelidir. Egerterapötik plazma afarezine ulasilabiliyor ise trigilserid düzeyi < 500 mg/dl olana kadar yapilmalidir.
Abstract
Background and Aims: Hypertriglyceridemia is the third most common cause of acute pancreatitis. This study investigated the characteristics and outcomes (recurrence and mortality) of patients presentingwith hypertriglyceridemia-induced acute pancreatitis. Materials andMethods: A total of 24 patients (average age: 38.8±6.5 years, 79%males) treated at our institution for severe hypertriglyceridemia-inducedacute pancreatitis between January 2010 and August 2017 were included in this study. Complete fasting lipid profiles, amylase and lipaselevels, and patient demographics were recorded for the evaluation ofsevere hypertriglyceridemia-induced acute pancreatitis.Results: A totalof 615 patients were admitted with acute pancreatitis in our institution within the study period. Severe hypertriglyceridemia-induced acutepancreatitis was present in 24 patients (3.9%). All patients showed significant improvement in their triglyceride levels with medical treatment[therapeutic plasmapheresis with standard treatment (20 patients) oronly standard treatment (4 patients)]. Of these patients 41.6% hadtype 2 diabetes mellitus, 16.6% had impaired glucose tolerance, 25%displayed excessive alcohol use, and 8.3% were pregnant. All theseconditions are known to be associated with hypertriglyceridemia. Hospital mortality was 4.1%, and recurrent pancreatitis was detected in29% of the patients.Conclusions: A high rate of recurrent pancreatitiswas observed, which may be related to irregular drug use, lack of dietcompliance, poor blood glucose regulation, and pregnancy. The lowmortality rate of 4.1% in this cohort may partly be due to aggressiveserum triglyceride lowering through a multidisciplinary team. Patientswith severe hypertriglyceridemia-induced acute pancreatitis should betreated quickly. If therapeutic plasma exchange is available, triglyceridelevels should be lowered to <500 mg/dl.
