[The clinical experience and plasmapheresis treatment outcome in treatment of hyperlipidemia acute pancreatitis among Uyghur].
OBJECTIVE
To investigate the clinical features and plasmapheresis treatment outcome of hyperlipidemic acute pancreatitis among Uyghur population.


METHODS
The clinical data of 41 cases (treatment group) diagnosed with acute hyperlipidemic pancreatitis and treated with plasmapheresis from August 2007 to August 2012 was studied, and treatment outcomes were statistically analyzed. Fifty patients during the same period who received medical treatment without plasmapheresis (control group) were collected, and were compared to the treatment group. Clinical data of 72 Han Chinese patients with hyperlipidemic acute pancreatitis from the same study period were compared to 91 Uyghur patients mentioned above. The data were analyzed by t-test or χ2 test.


RESULTS
Treatment group and control group were comparable in terms of gender, age, APACHE II score at admission, BMI, and blood lipid levels. Thirty-two patients out of 41 in the treatment group were improved after routine medical treatment and plasmapheresis, but 9 died. In the control group, 28 out of 50 cases were improved, 22 died. The mortality of the treatment group was significantly lower than that of the control group(χ2 = 10. 824, P = 0. 001). Time of hospital stay in treatment group was (17 ± 16) days, and significantly shorter than that of control group ((28 ± 20) days) (t= 2. 851, P = 0. 005). Before plasmapheresis in the treatment group, serum triglyceride and total cholesterol levels were (58 ± 39) mmol/L and (24 ± 8) mmol/L, after plasmapheresis, these values dropped significantly to (10 ± 10) mmol/L and (6 ± 5) mmol/L. APACHE II score of those died were 18 ± 2, and significantly higher than those who survived(11 ± 3) (t = 0. 570, P = 0. 000); Time from hospital admission until plasmapheresis were significantly longer in died patients ((49 ± 9) hours) than in survived patients ((38 ± 8) hours, t = 3. 549, P = 0. 040). Furthermore, serum triglyceride levels were significantly higher in survived cases ((46 ± 16) mmol/L) than those who died ((37 ± 15) mmol/L) (t = 2. 386, P = 0. 010) . Both serum triglyceride and cholesterol levels were reduced significantly in control group (t = 3. 484, P = 0. 00; t = 4. 086, P = 0. 000, but the degrees of reduction were significantly lower than that of the treatment group. When comparing Uyghur patients to Han patients, Uyghur cases had higher serum triglyceride (t = 2. 083, P = 0. 039), and cholesterol levels (t = 2. 535, P = 0. 012, and their age was significantly younger than that of Hans (t = 3. 373, P = 0. 010 .


CONCLUSIONS
s Uyghur patients with hyperlipidemia acute pancreatitis tend to have higher serum triglyceride and cholesterol levels, and age at disease onset is younger. Plasmapheresis is a more effective treatment option for patients with hyperlipidemia acute pancreatitis. Treatment outcome is related to APACHE II score, serum triglyceride levels, and time frame between admission and plasmapheresis treatment.
Amutijiang
A
Mahemuti
Abudoushalamu
A
Abudoureyimu
Ge
G
Chen
D018806:APACHE; D000208:Acute Disease; D044466:Asian People; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000628:therapy*; D007902:Length of Stay; D010195:Pancreatitis / Q000150:complications / Q000628:therapy*; D010956:Plasmapheresis; D061665:Time-to-Treatment; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
D014280:Triglycerides