高脂血症型急性胰腺炎患者CRRT不同介入时机的乳酸清除率与治疗28天生存率的比较研究

doi:10.3969/j.issn.1001-8131.2025.06.003

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摘要目的探究高脂血症型急性胰腺炎患者连续性肾脏替代治疗（CRRT）不同介入时机的乳酸清除率与治疗28d生存率的比较。方法回顾性选取98例高脂血症型急性胰腺炎患者为研究对象,纳入病例组,根据CRRT的介入时机将其分为早期组53例和晚期组45例,对比两组的临床资料,乳酸清除率及血清学指标;Kaplan-Meier生存分析患者28d生存率。结果早期组和晚期组在年龄、性别及呼吸频率等一般资料比较差异无统计学意义（P>0.05）;早期组24h乳酸清除率、48h乳酸清除率均显著高于晚期组（P<0.05）;治疗后,早期组AMY、TNF-α、IL-1β、PCT水平相较于晚期组显著更低P<0.05）;Kaplan-Meier生存分析显示,早期组28d总体生存率明显高于晚期组（P<0.05）。结论早期CRRT介入可显著提高高脂血症型急性胰腺炎患者的乳酸清除率,降低炎症指标,并显著改善28d生存率。因此,早期CRRT治疗为改善HLAP患者预后的有效策略。

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	郑志恒
	张雷明
	朱国强
	肖晶晶

关键词 ：高脂血症性急性胰腺炎, 连续性肾脏替代治疗（CRRT）, 不同介入时机, 乳酸清除率, 治疗28d生存率

Abstract：Objective To investigate the impact of different initiation timings of continuous renal replacement therapy(CRRT)on lactate clearance rate and 28-day survival in patients with hyperlipidemic acute pancreatitis. Methods 98 patients with hyperlipidemic acute pancreatitis admitted to our hospital from January were selected retrospectively and included in the case group.According to the intervention opportunity of CRRT,they were divided into early group(53 cases)and late group(45 cases),and the clinical data,lactate clearance rate and serological indexes of the two groups were compared.Kaplan-Meier survival analysis patients' 28-day survival rate. Results There was no significant difference in age,sex and respiratory rate between the early group and the late group(P>0.05).The 24-hour lactate clearance rate and 48-hour lactate clearance rate in early group were significantly higher than those in late group and,respectively(P<0.05).After treatment,the levels of AMY,TNF-αmL,IL-1βand PCT in the early group.Kaplan-Meier survival analysis showed that the overall survival rate of early group was,which was significantly higher than that of late group（P<0.05）. Conclusion Early CRRT intervention significantly enhances lactate clearance,reduces inflammatory markers,and improves 28-day survival rates in hyperlipidemic acute pancreatitis(HLAP)patients,demonstrating its efficacy as a therapeutic strategy for prognosis improvement.

Key words： Hyperlipidemic acute pancreatitis Continuous Renal Replacement Therapy Intervention timing Lactate clearance 28-day survival rate

收稿日期: 2025-07-22

PACS:

R657.5+1

基金资助:2024-2025年南阳市科技攻关项目（24KJGG001）

通讯作者: 肖晶晶

引用本文:

郑志恒, 张雷明, 朱国强, 肖晶晶. 高脂血症型急性胰腺炎患者CRRT不同介入时机的乳酸清除率与治疗28天生存率的比较研究[J]. 哈尔滨医药, 2025, 45(6): 10-13.
Zheng Zhiheng, Zhang Leiming, Zhu Guoqiang, Xiao Jingjing. Comparative Study on Lactate Clearance Rate and 28-day Survival Rate of Patients with Hyperlipidemia Acute Pancreatitis Treated with CRRT at Different Intervention Opportunities. journal1, 2025, 45(6): 10-13.

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http://www.hrbyybjb.org.cn/CN/10.3969/j.issn.1001-8131.2025.06.003 或 http://www.hrbyybjb.org.cn/CN/Y2025/V45/I6/10

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