早期低热量营养支持在轻型高脂血症胰腺炎中的应用

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Abstract Objective To study the application of early low calorie nutritional support on mild hyperlipidemic acute pancreatitis(HLAP)patients.Methods A total of 46 patients with mild HLAP in the First Affiliated Hospital of Xiamen University from March to November 2020 were selected as the rasearch objects and divided into the standard calorie group and the low calorie group by random number table method,with 23 cases in each group.In early disease stage,the standard calorie group patients were supplied with a nutritional support of 24 kcal/kg per day,while the low calorie group patients were supplied with a nutritional support of 11 kcal/kg per day.After 3 days of different nutritional support,the therapeutic effect(including triglyceride[TG],amylase[AMY],lipase[LIP],C-reaction protein[CRP],interleukin-6[IL-6]and procalcitonin[PCT]),gastrointestinal function recover time(including the remission time of abdominal pain and distension,first exhausting/defecating time and the time of intestinal peristaltic sound resuming to 5 times/minute),incidence of hypoglycemia(blood glucose＜2.8 mmol/L)and prognosis(including severity progress,fatality rate and hospital stay length)were compared.Results After 3 days of treatment,TG,CRP and IL-6 in low calorie group were lower than those in standard calorie group,and the differences were statistically significant(P＜0.05).There were no statistically significant differences in AMY,LIP and PCT between the two groups after 3 days of treatment(P ＞0.05).There were no statistically significant differences in the relief time of abdominal pain and distension,the time for the first exhaust or defecation and the time for the recovery of bowel sounds to 5 times/min between the two groups(P＞0.05).No hypoglycemia occurred in the two groups.There was no statistically significant difference in the incidence of disease progression to moderate severe acute pancreatitis(MSAP)between the two groups(P＞0.05).No patients in the two groups progressed to severe acute pancreatitis(SAP)or died.The length of hospital stay in the low calorie group was shorter than that in the standard calorie group,and the difference was statistically significant(P＜0.05).Conclusion For mild HLAP patients,early low calorie nutritional support could promote serum lipid reduction,improve inflammation condition,shorten the hospital stay length,and will not affect the recovery of gastrointestinal function or increase the incidence of hypoglycemia,which provide a reference for clinicians to choose a better nutritional support for mild HLAP patients.

Key words： Hyperlipidemic pancreatitis Low calorie Standard calorie Nutrition

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	TU Yun-fan
	LIN Pei-wen

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TU Yun-fan,LIN Pei-wen. Application of early low calorie nutritional support on mild hyperlipidemic acute pancreatitis[J]. 中国当代医药, 2021, 28(26): 27-30.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2021/V28/I26/27

[6]	何新华，郭树彬.中国急诊营养治疗推荐[J].中华急诊医学杂志，2020，29（9）：1148-1154.
[8]	杜奕奇，陈其奎，李宏宇，等.中国急性胰腺炎诊治指南（2019年，沈阳）[J].临床肝胆病杂志，2019，35（12）：2706-2711.
[9]	马江辰，保志军.高脂血症性急性胰腺炎发病机制的研究进展[J].国际消化病杂志，2017，37（1）：24-27.
[3]	周梦婷，喻冰君，何文华，等.急性高三酰甘油血症性胰腺炎的诊治进展[J].中华胰腺病杂志，2019，19（5）：379-382.
[1]	Hansen SEJ，Madsen CM，Varbo A，et al.Low-grade inflammation in the association between mild-to-moderate hypertriglyceridemia and risk of acute pancreatitis：a study of more than 115000 individuals from the general population[J].Clin Chem，2019，65（2）：321-332.
[2]	Sezgin O，O，Yaras S，et al.Evaluation of hypertriglyceridemia-induced acute pancreatitis：A single tertiary care unit experience from Turkey[J].Turk J Gastroenterol，2019，30（3）：271-277.
[4]	Arvanitakis M，Ockenga J，Bezmar evic M，et al.ESPEN guideline on clinical nutrition in acute and chronic pancreatitis[J].Clin Nutr，2020，39（3）：1-17.
[5]	Singer P，Blaser AR，Berger MM，et al.ESPEN guideline on clinical nutrition in the intensive care unit[J].Clin Nutr，2019，38（1）：48-79.
[7]	Elke G，Hartl WH，Kreymann KG，et al.Clinical Nutrition in Critical Care Medicine-Guideline of the German Society for Nutritional Medicine（DGEM）-ScienceDirect[J].Clin Nutr，2019，32（33）：220-275.
[10]	LU Z，LI M，GUO F，et al.Timely reduction of triglyceride levels is associated with decreased persistent organ failure in hypertriglyceridemic pancreatitis[J].Pancreas，2020，49（1）：105-110.
[11]	Strate T，Mann O，Kleinhans H，et al.Systemic intravenous infusion of bovine hemoglobin significantly rat[J].Ann Surg，2003，238（5）：765-771.
[12]	张琪月，朱如萍，唐国都，等.血液净化治疗高脂血症性胰腺炎的研究进展[J].国际消化病杂志，2020，40（2）：109-112，118.
[13]	贺承健，姚泓屹，封萍.早期低热卡与高热卡营养治疗高脂血症性重症急性胰腺炎的临床疗效比[J].肠外与肠内营养，2018，25（3）：171-175
[14]	周春燕，药立波.生物化学与分子生物学[M]北京：人民卫生出版社，2018：211-218
[15]	邓明华，陈建中，王亚峰，等.持续大容量低营养静脉补液治疗高脂血症性急性胰腺炎的疗效分析[J].现代医药卫生，2019，35（19）：2936-2938.
[16]	郭浚，胡刚，曹梦娟.PCT、hs-CRP 及IL-6 的水平变化对急性胰腺炎的临床意义[J].胃肠病学和肝病学杂志，2014，23（12）：1471-1474.
[17]	杜奕奇，李维勤，毛恩强.中国急性胰腺炎多学科诊治（MDT）共识意见（草案）[J].中国实用内科杂志，2015，35（12）：1004-1010.
[18]	Suang W，Navaneethan U，Ruiz L，et al.Hypertriglyceridemicpancreatitis：presentation and management[J].Am J Gastroenterol，2009，104（4）：984-991