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| 摘要: |
| 目的探讨高原藏区急性胰腺炎(acute pancreatitis,AP)的病因。方法回顾性收集阿坝藏族羌族自治州人民医院消化内科2013年1月到2016年1月AP患者的病历资料。按民族、性别、年龄、城乡、县域(草地县和非草地县)以及文化程度分组进行病因对比分析,有意义差别项纳入logistic回归分析。结果高原藏区AP的病因仍以胆源性、酒精性及高脂血症为主,在不同民族、居民、县域、文化程度之间差异无统计学意义(X~2:13.572,6.741,9.251,21.545;P:0.059,0.456,0.235,0.088);在不同性别之间,男性以酒精性为主,不明原因性较多,女性以胆源性、高脂血症性为主,差异有统计学意义(P<0.05);不同年龄分组,高龄组以胆源性为主,低龄组以酒精性为主,中等年龄组以高脂血症为主,差异有统计学意义(X~2:27.803,40.137;P:0.000,0.000)。Logistic回归分析提示:不同性别间(二元),男性酒精性、不明原因性为其独立危险因素;女性胆源性、高脂血症为其独立危险因素,不同年龄组(多元),高龄组以胆源性、低龄组以酒精性、中等年龄组以高脂血症为独立危险因素[不同性别间,男性酒精性(OR=15.247,95%CI:1.106~7.836,P=0.006),男性不明原因性(OR=8.162,95%CI:0.196~1.836,P=0.016),女性胆源性(OR=20.318,95%CI:,1.014~6.436,P=0.001),女性高脂血症(OR=10.785,95%CI:1.506~5.066,P=0.002);不同年龄组,高龄组胆源性(OR=6.016,95%CI:0.080~0.754,P=0.014),低龄组酒精性(OR=20.172,95%CI:0.118~0.433,P=0.000),中等年龄组(OR=27.164,95%CI:1.027~9.529,P=0.000)]。结论高原藏区AP因性别及年龄不同而存在差异,在疾病的预防和治疗中须采取相应不同的处置。 |
| 关键词: 高原 藏区 急性胰腺炎 病因 |
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| Etiology of Alute Pancreatitis in Higlond Tiketan Areas |
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Kang Lesiji;Yang Lin;Jin Zhenghui
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Aba Tibetan and Qiang Autonomous Prefecture people’s Hospital in Sichuan province
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| Abstract: |
| Objective To investigate the etiology of acute pancreatitis( acutepancreatitis,AP) in Tibetan Plateau.Methods The clinical records of AP patients from January 2013 to January 2016 in the digestive department of the people’s Hospital of Aba Tibetan and Qiang Autonomous Prefecture were retrospectively collected.According to the national,gender,age,urban and rural areas,counties( grassland counties and no-grassland counties) and education groups,the causes of the disease were compared and analyzed.And the significant differences were included in the logistic regression analysis.Results The etiology of AP in Tibetan Plateau area was mainly biliary,alcoholic and hyperlipidemia,no significant difference between different nationalities,residents,county,and the degree of Education( X~2: 13. 572,6. 741,9. 251,21. 545; P: 0. 059,0. 456,0. 235,0. 088); Among the different sexes,the etiology of AP for male was mainly alcohol,with unknown reasons,and for female were mainly biliary and hyperlipidemia,with statistically significant difference.In different age groups,the elderly group was mainly biliary,the younger group was mainly alcohol,and the middle age group was mainly hyperlipidemia( X~2: 27. 803,40. 137; P: 0. 000,0. 000). Logistic regression analysis suggested that among different genders( Er Yuan),alcohol and unknown reason were independent risk factors for male,while biliary and hyperlipidemia were independent risk factors for women.In different age of groups( multivariate),the independent risk factorswere biliary,alcohol,and hyperlipidemia in elderly group,in the younger group and in the middle age group,respectively[Among the different sexes,alcohol of male( OR = 15. 247,95%CI: 1. 106 ~ 7. 836,P = 0. 006),unknown reason of male( OR = 8. 162,95%CI: 0. 196 ~ 1. 836,P = 0. 016),biliary of female( OR = 20. 318,95% CI:,1. 014 ~ 6. 436,P = 0. 001),hyperlipidemia of female( OR=10. 785,95%CI: 1. 506 ~ 5. 066,P = 0. 002); In different age of groups,biliary in elderly group( OR = 6. 016,95% CI:0. 080 ~ 0. 754,P = 0. 014),alcohol in younger group( OR = 20. 172,95% CI: 0. 118 ~ 0. 433,P = 0. 000),middle age group( OR =27. 164,95%CI: 1. 027 ~ 9. 529,P = 0. 000) ].Conclusion The Tibetan Plateau AP for gender and age differences in the prevention and treatment of diseases must take the appropriate disposal. |
| Key words: plateau tibetanarea acutepancreatitis etiology |
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