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The changes and significance of multiple organ functions in acute pancreatitis patients under hypoxic condition on plateau

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Author:
No author available
Journal Title:
CHINESE CRITICAL CARE MEDICINE
Issue:
4
DOI:
10.3760/cma.j.issn.1003-0603.2010.04.006
Key Word:
胰腺炎,急性;高原;红细胞增多症;多器官功能衰竭;Acute pancreatitis;High altitude;Erythrocythemia;Multiple organ function failure

Abstract: Objective To explore characteristics of the pathogenesis and progression of the acute pancreatitis CAP) in high altitude and the relationship between AP and plateau erythrocythemia. Methods Retrospective analysis of the clinical data of AP was conducted for 103 inpatients who were admitted during 2003 and 2005 to the People's Hospital of Qinghai Province, including 12 cases of AP complicated with plateau erythrocythemia and 91 cases of AP no complicating plateau erythrocythemia. The patients were divided into a group of 57 cases living in high altitude (>3 000 m) and 46 patients in lower altitude group (<2 200 m). Clinical data of the patients were collected at admission, and liver, kidney and lung functions were determined for all patients. Results Alanine aminotransferase (ALT) and creatinine (Cr) were significantly higher in AP complicating plateau erythrocythemia compared with AP patients without complicating plateau ery-throcythemia [ALT: (160.70±19.14) U/L vs. (78.00±14.96) U/L, Cr: (135.45±11.99) μmol/L vs. (91.42±17.08) μmol/L, both P<0.05]. Arterial partial pressure of oxygen (PaO-2) and arterial oxygen saturation (SaO_2) were significantly lower in AP with complication of plateau erythrocythemia than in AP without complicating plateau erythrocythemia [PaO_2: (45.10±0.40) mm Hg vs. (65.48±1.36) mm Hg, 1 mm Hg=0.133 kPa, SaO_2: 0.851±0.004 vs. 0.940±0.009, both P<0.05]. There was no difference in aspartate aminotransferase (AST), blood urea nitrogen (BUN) and arterial partial pressure of carbon dioxide (PaCO_2), however, their levels were higher in plateau erythrocythemia cases than those without plateau erythrocythemia [AST: (87.35±8.10) U/L vs. (83.00±18.61] U/L, BUN: (10.90±0.97) mmol/L vs. (7.37±0.98) mmol/L, PaCO_2: (33.20±0.31) mm Hg vs. (25.32± 1.14) mm Hg, all P>0.05]. ALT and Cr were significantly higher in high altitude cases than those in lower altitude cases [ALT: (126.92±15.46) U/L vs. (86.00±10.23) U/L, Cr: (126.10±10.01) μmol/L vs. (101.84±5.46) μmol/L, both P<0.05]. There was no difference in AST, BUN and PaCO_2, however, the values were slightly higher in high altitude cases compared with lower altitude cases CAST: (98.70± 8.10) U/L vs. (93.14±21.46) U/L, BUN: (8.15±1.00) mmol/L vs. (5.86±0.40) mmol/L, PaCO_2: (32.32±1.01) mm Hg vs. (30.12±2.76) mm Hg, all P>0.05]. There was no difference in PaO_2 and SaO_2, however, it was slightly lower in high altitude cases than lower altitude cases [PaO_2: (58.80± 1.20) mmHg vs. (66.86±3.20) mm Hg, SaO_2: 0.910±0.011 vs. 0.930±0.008, both P>0.05]. Conclusion The results showed that the deterioration of hepatic, kidney and lung function in AP patients living in the plateau was related to high altitude and erythrocythemia.

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