2021 年第 3 期 第 16 卷

中老年急性胰腺炎患者临床特点分析

Analysis of clinical characteristics of middle-aged and elderly patients with acute pancreatitis

作者：赵丹丹张玫

英文作者：Zhao Dandan Zhang Mei

单位：首都医科大学宣武医院消化科，北京100053

英文单位：

关键词：急性胰腺炎；中老年；临床特点

英文关键词：Acutepancreatitis;Middle-agedandelderly;Clinicalcharacteristics

• 摘要：

• 目的 探讨中老年急性胰腺炎（AP）患者的临床特点。方法 回顾性分析2017年2月至2018年1月首都医科大学宣武医院收治的95例AP患者的临床资料，按照年龄将其分为青年组（48例）和中老年组（47例）。分析比较2组患者的病因、临床表现、合并疾病以及AP并发症和病情严重程度分级。结果 中老年AP患者的主要病因是胆道疾病，比例高于青年组［55.3%（26/47）比6.2%（3/48）］，差异有统计学意义（P<0.05）。2组患者的临床症状、体征比较差异均无统计学意义（均P>0.05）。中老年患者合并糖尿病、高血压、冠心病（冠状动脉粥样硬化性心脏病）比例较高［27.7%（13/47）比8.3%（4/48）、23.4%（11/47）比6.2%（3/48）、21.3%（10/47）比4.2%（2/48）］，差异均有统计学意义(均P<0.05)。中老年患者AP病程中呼吸衰竭发生率明显高于青年组，差异有统计学意义（P<0.05）。中老年组中度重症及重症AP比例略高于青年组，轻症比例略低于青年组。结论 中老年AP患者在病因、合并疾病、并发症以及严重程度等方面均有其特点。中老年AP患者伴有较多的慢性基础疾病，易发展为重症AP，需要临床医师提高警惕。

• Objective To explore the clinical characteristics of middle-aged and elderly patients with acute pancreatitis(AP). Methods The clinical data of 95 AP patients admitted to Xuanwu Hospital, Capital Medical University from February 2017 to January 2018 were retrospectively analyzed. They were divided into young group(48 cases) and middle-aged and elderly group (47 cases) according to their age. Pathogeny, clinical manifestations, concomitant diseases and complications of AP and severity of illness of the two groups were analyzed and compared. Results The main cause of middle-aged and elderly patients with AP was biliary disease, the proportion of that in middle-aged and elderly group was higher than that in young group［55.3%（26/47） vs 6.2%（3/48）］（P<0.05）. There were no significant differences in the clinical symptoms and signs between the two groups of patients（all P>0.05）. There were more proportions of middle-aged and elderly patients with diabetes, hypertension, and coronary atherosclerotic heart disease［27.7%（13/47） vs 8.3%（4/48）， 23.4%（11/47） vs 6.2%（3/48）， 21.3%（10/47） vs 4.2%（2/48）］（all P<0.05）. The incidence of respiratory failure in the course of AP in middle-aged and elderly patients was significantly higher than that in young group（P<0.05）. The proportion of moderately severe and severe AP in the middle-aged and elderly group were slightly higher than those in the young group, and the proportion of mild AP in the middle-aged and elderly group was slightly lower than that in the young group. Conclusions Middle-aged and elderly patients with AP have their own characteristics in  etiology, comorbidities, complications, and severity. Middle-aged and elderly patients with AP are accompanied by a variety of chronic diseases and are prone to develop severe AP, which requires the attention of clinicians.