目的 对比双重滤过血浆置换与血浆吸附2种不同的血液净化治疗模式治疗高甘油三酯血症性急性胰腺炎(hypertriglyceridemia-associated pancreatitis，HTG-AP)的临床效果。 方法 回顾性纳入2021年5月─2023年4月三亚市人民医院及吉林市人民医院收治的75例HTG-AP患者的临床资料：双重滤过血浆置换(double filtration plasmapheresis,DFPP)组患者24例、血浆吸附(plasma adsorption,PA)组26例、常规治疗组25例，比较3组治疗后的生化指标、禁食时间、72h腹痛缓解率、并发症情况、住院费用、复发率等方面的差异。 结果 DFPP组血液净化治疗后24h内复查血清三酰甘油、胆固醇、超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)下降幅度大于常规治疗组(t=8.136、4.577、3.671、2.241，P＜0.001、＜0.001、0.001、0.030)，PA组复查血清三酰甘油、胆固醇、hs-CRP、血清淀粉样蛋白A(serum amyloid A,SAA)、IL-6下降幅度大于常规治疗组(t=10.533、4.679、3.347、3.622、2.356，P＜0.001、＜0.001、0.002、0.001、0.023)。DFPP组与常规组复发率比较具有统计学意义(χ2=6.050, P=0.049)，3组间住院总费用差异无统计学意义(F=1.787，P=0.175)。 结论 DFPP及PA是2种可快速有效降低血脂的血液净化治疗方法，有利于阻断炎症反应，减少发生重症的概率，获得较好的临床疗效。
Objective To compare the clinical effects of two blood purification modalities, dual filtration plasma exchange and plasma adsorption, in the treatment of hyperlipidemic acute pancreatitis (HTG-AP). Methods Clinical data of the 75 HTG-AP patients admitted to Sanya People's Hospital or Jilin People's Hospital from May 2021 to April 2023 were retrospectively studied. There were 24 cases in the double filtration plasmapheresis (DFPP) group, 26 cases in the plasma adsorption (PA) group, and 25 cases in the conventional treatment group. Biochemical indexes, fasting time, abdominal pain relief rate after 72h, complications, hospitalization expenses and recurrence rate were compared among the three groups after the treatment. Results Serum triacylglycerol, cholesterol, hs-CRP and interleukin 6 (IL-6) decreased more in the DFPP group within 24h after the treatment than in the conventional treatment group (t=8.136, 4.577, 3.671 and 2.241 respectively; P＜0.001, ＜0.001, =0.001 and =0.030 respectively). Serum triacylglycerol, cholesterol, hs-CRP, serum amyloid A (SAA) and IL-6 decreased more in the PA group than in the conventional treatment group (t=10.533, 4.679, 3.347, 3.622 and 2.356 respectively; P＜0.001, ＜0.001, =0.002, =0.001 and =0.023 respectively). However, there were no statistical differences in these biochemical indexes between the DFPP group and the PA group (P＞0.05). The recurrence rate had statistical difference between the DFPP group and the conventional group (χ2=6.050, P=0.049). There were no statistical differences in total hospitalization expenses among the three groups (F=1.787, P=0.175). Conclusion DFPP and PA are two blood purification treatment modalities that can rapidly and effectively reduce serum lipids. They are beneficial to block inflammatory responses, reduce the chance to develop serious illnesses, and obtain better clinical efficacies.
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