临床荟萃 ›› 2024, Vol. 39 ›› Issue (3): 239-243.doi: 10.3969/j.issn.1004-583X.2024.03.007

• 论著 • 上一篇    下一篇

新型冠状病毒肺炎合并急性胰腺炎11例临床特征分析

魏芳1, 张羽2, 王青青1, 郑国启1()   

  1. 1.沧州市中心医院 消化内科,河北 沧州 061001
    2.沧州河间中医院 消化内科,河北 沧州 062450
  • 收稿日期:2023-12-29 出版日期:2024-03-20 发布日期:2024-06-12
  • 通讯作者: 郑国启 E-mail:xhkzgq@sina.com

Clinical analysis of 11 cases of coronavirus disease-19 associated with acute pancreatitis: Case report

Wei Fang1, Zhang Yu2, Wang Qingqing1, Zheng Guoqi1()   

  1. 1. Department of Gastroenterology, Cangzhou Central Hospital, Cangzhou 061001, China
    2. Department of Gastroenterology, Hejian Hospital of Traditional Chinese Medicine, Cangzhou 062450, China
  • Received:2023-12-29 Online:2024-03-20 Published:2024-06-12
  • Contact: Zheng Guoqi E-mail:xhkzgq@sina.com

摘要:

目的 探讨新型冠状病毒肺炎(COVID-19)合并急性胰腺炎(AP)患者的临床特征及两者关系。方法 回顾性收集2022年12月15日至2023年1月15日沧州市中心医院和河间中医院诊治的11例COVID-19合并AP患者的年龄、性别、临床表现、实验室检查、影像学检查等进行分析。结果 11例患者中男性8例,女性3例。年龄29~79岁。COVID-19轻型10例、中型1例。轻型急性胰腺炎8例,中度重症急性胰腺炎2例,重度急性胰腺炎1例。消化系统表现中腹痛11例,伴恶心呕吐4例,腹泻1例。11例患者均行以下检查:血淀粉酶139(38~851) U/L,血甘油三脂2.57(0.69~4.2) mmol/L,8例患者血脂肪酶74(27~196) U/L。3例既往有糖尿病史的患者发病后空腹血糖较前升高2~4 mmol/L。5例患者氢甲烷呼气试验阳性。结论 COVID-19合并AP以男性多见,COVID-19轻型多见,合并AP时以轻型急性胰腺炎多见。COVID-19可引起腹痛、腹泻等消化道症状,并对AP患者的血脂、血糖、肠道菌群产生影响,可能是AP的病因。

关键词: 新型冠状病毒肺炎, 急性胰腺炎, 血脂, 血糖, 小肠细菌过度生长, 临床特征

Abstract:

Objective To explore the clinical characteristics of coronavirus disease 2019 (COVID-19) associated with acute pancreatitis (AP), and analyze the correlation between the two. Methods A retrospective analysis was conducted on 11 patients with COVID-19 and AP treated at Cangzhou Central Hospital and Hejian Hospital of Traditional Chinese Medicine from December 15, 2022, to January 15, 2023, including analysis of age, gender, clinical manifestations, laboratory examinations, and imaging studies. Results Among the 11 patients, 8 were male and 3 were female, with ages ranging from 29 to 79 years. Ten cases were categorized as mild COVID-19, with one case being moderate. Eight cases presented with mild acute pancreatitis (MAP), two cases with moderate-severe acute pancreatitis (MSAP), and one case with severe acute pancreatitis (SAP). The manifestations in common digestive showed there were 11 cases of abdominal pain, 4 cases of nausea and vomiting, and 1 case of diarrhea. Laboratory findings showed blood amylase levels of 139 (38-851) U/L, blood triglyceride levels of 2.57 (0.69-4.2) mmol/L, and lipase levels of 74 (27-196) U/L in 8 patients. Among patients with a history of diabetes, fasting blood glucose levels increased by 2-4 mmol/L after onset in 3 cases. Five patients presented positive for hydrogen and methane breath test. Conclusion In patients with COVID-19 and AP, males were more commonly affected, with a predominance of mild COVID-19, and MAP was more prevalence in patients with APCOVID-19 and AP. COVID-19 may lead to gastrointestinal symptoms such as abdominal pain and diarrhea, affecting blood lipids, blood sugar, and intestinal microbiota in AP patients, potentially contributing to the pathogenesis of AP.

Key words: novel coronavirus pneumonia, acute pancreatitis, blood lipids, blood sugar, intestinal bacterial overgrowth, clinical features

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