目的探讨并比较连续性血液滤过(continuous veno-venous hemofiltration，CVVH)与CVVH 联合血浆置换(plasma exchange，PE)2 种治疗方式在治疗妊娠期高脂血症性胰腺炎(hyperlipidemic acute pancreatitis in pregnancy，HLAPIA)中的临床疗效。方法郑州大学附属洛阳市中心医院2011 年5 月到2017 年5 月被收治入院的妊娠期高脂血症性胰腺炎30 例病例，随机分为2 组，均给予常规内科治疗。CVVH 组另予持续血液滤过，疗程5d；CVVH+PE 组另予持续血液滤过，疗程5d，同时予以血浆置换3 次。比较2 组患者治疗有效率、症状缓解时间、禁食时间、住院时间及相关实验室血液指标之间的差异。结果CVVH+PE 组的治疗有效率为93.33%，高于CVVH 组53.33%，且2 组间有统计学差异(P=0.035)。CVVH+PE 组症状缓解时间(t=3.850，P＜0.001)、禁食时间(t=5.290，P＜0.001)与住院时间(t=4.890，P＜0.001)均显著低于CVVH 组，差异有统计学意义。治疗后，CVVH+PE 组的白细胞(t=4.870，P＜0.001)、C 反应蛋白(t=10.390，P＜0.001)、三酰甘油(t=5.230，P＜0.001)、总胆固醇(t=5.370，P＜0.001)明显低于CVVH组，而2 组之间的淀粉酶(amylase AMY)、脂肪酶(lipase LPS)则无明显差异。

Objective To study the prognosis of hyperlipidemic acute pancreatitis in pregnancy (HLAPIP) patients treated by continuous veno- venous hemofiltration (CVVH) or CVVH plus plasma exchange (PE). Methods We recruited 30 patients diagnosed with HLAPIP in Luoyang Central Hospital, Zhengzhou University and randomly divided them into 2 groups. The CVVH group received CVVH for 5 days, and the CVVH+PE group received plasma exchange 3 times in addition to CVVH5 for 5 days. We then compared treatment efficiency, symptom alleviating time, fasting time, hospitalization days and laboratory blood indices between the two groups. Results The treatment efficiency is 93.33% in CVVH + PE group, higher than 53.33% (P=0.035) in CVVH group. The symptom alleviating time (t =3.850, P＜0.001), fasting time (t =5.290, P＜0.001), hospitalization days (t =4.890, P＜0.001) are shorter in CVVH+PE group than in CVVH group. After the treatment, white blood cell (t =4.870, P＜0.001), C response protein (t=10.390, P＜0.001), triglyceride (t =5.230, P＜0.001) and total cholesterol (t =5.370, P＜0.001) are lower in CVVH+PE group than in CVVH group; while amylase and lipase have no significant differences between the two groups.