Hypertriglyceridemia-Induced Pancreatitis: A Decade of Experience in a Community-Based Teaching Hospital.

血浆置换术 医学 高甘油三酯血症 胰腺炎 胰岛素 急性胰腺炎 糖尿病 胃肠病学 皮下注射 内科学 外科 儿科 内分泌学 甘油三酯 免疫学 胆固醇 抗体
作者
Maxwell Eyram Afari,Hammad Shafqat,Muhammad Shafi,Fady Marmoush,Mary B. Roberts,Taro Minami
出处
期刊:PubMed 卷期号:98 (12): 40-3 被引量:10
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Hypertriglyceridemia is the third most common cause of acute pancreatitis. The current evidence on the management of hypertriglyceridemia-induced pancreatitis (HTGP) is mainly derived from case series. It has been suggested that insulin, and plasmapheresis have a role in the management of acute HTGP. We present a retrospective review of patients seen at a community-teaching hospital between 2005 and 2015.Out of the 549 admissions for acute pancreatitis, fourteen patients met our inclusion criteria. The mean age of presentation was 39± 8 years and there was a predominance of men (57%). More than two-thirds of the patients were admitted to the intensive care unit. The majority of the patients were treated with insulin drip (n=8), and the rest by subcutaneous insulin (n=3) and insulin drip + plasmapheresis (n=3). In the insulin drip group we noted a gradual decrease of the admission serum triglycerides by 50.6 ±16.0 % at 24 hours, 65.9±16.9% at 48 hours, and then 85.2± 7.1% at discharge. Serum triglycerides decreased by 79.8% and 92.6%, at discharge in the subcutaneous insulin and insulin + plasmapheresis cohorts, respectively. The insulin + plasmapheresis cohort stayed in the hospital longer (20.7±3.1 days) compared to the insulin drip (10.3±5.4 days) and subcutaneous insulin (5.7 ± 1.2 days) cohorts.Our study strengthens the evidence for using insulin (infusion or subcutaneous) with or without plasmapheresis in the treatment of hypertriglycerimia-induced pancreatitis.

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