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Journal of Chinese Integrative Medicine ›› 2005, Vol. 3 ›› Issue (6): 443-445.doi: 10.3736/jcim20050606

• Original Clinical Research • Previous Articles     Next Articles

Clinical study on severe acute pancreatitis associated with hypoalbuminemia in early stage

Ping Xue, Zong-wen Huang, Yong-hong Li, Jia Guo, Zhong-chao Wang, Jian-lei Zhao, Zhen You   

  1. Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, China
  • Received:2005-06-05 Online:2005-11-20 Published:2005-11-20
  • Contact: Zong-wen Huang E-mail:huangzongwen@medmail.com.cn

Objective

To investigate the occurring mechanism and clinical characteristics of severe acute pancreatitis (SAP) associated with hypoalbuminemia in early stage and its influence on prognosis of SAP and the preventive and therapeutic management of this disease.

Methods

One hundred and thirty-eight cases diagnosed as SAP complicated by hypoalbuminemia in early stage were accepted in our hospital from August 1, 2003 to December 31, 2004, and they were divided into 2 groups according to the level of plasma albumin: mild hypoalbuminemia (30 to 35 g/L) group and severe hypoalbuminemia (<30 g/L) group. The complications in the early stage, related parameters, and the incidence rate of infection and mortality in the later stage were evaluated respectively.

Results

The incidence rates of renal dysfunction, shock, cardiovascular failure and gastrointestinal hemorrhage, the score of acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) and the frequencies of pulse and breath in the severe hypoalbuminemia group were all higher than those in the mild hypoalbuminemia group (P<0.05 or P<0.01). The differences of incidence rate of hepatic failure and the scores of Ranson and Balthazar CT between these two groups had no statistical significance (P>0.05). The incidence rate of infection and the mortality in the severe hypoalbuminemia group were higher than those in the mild hypoalbuminemia group (P<0.01) in the later stage of SAP.

Conclusion

Hypoalbuminemia in the early stage can accelerate the deterioration in pathophysiology of SAP. The lower level of the plasma albumin is in the early stage, the more complications and the higher incidence rate of infection and mortality will be in the later stage. To relieve the extent of systemic inflammatory response syndrome (SIRS) and abundant supplement of albumin, amino acid and lipid in time may be crucial to prevent the occurrence and deterioration of hypoalbuminemia.

Key words: Pancreatitis, Acute necrotizing, Hypoalbuminemia, Clinical studies

CLC Number: 

  • R576.1

Tab 1

Comparison of early complications in 2 groups [cases (%)]"

Group n ARDS Renal dysfunction Shock Cardiovascular
failure
Hepatic failure Gastrointestinal
hemorrhage
Mild hypoalbuminemia 54 27 (50.0) 10 (18.5) 6 (11.1) 8 (14.8) 24 (44.4) 2 (3.7)
Severe hypoalbuminemia 84 55 (65.5) 35 (41.7)** 32 (38.1)** 35 (41.7)** 39 (46.4) 20 (23.8)**

Tab 2

Comparison of early relative parameters in 2 groups (to be continued) ($\bar{x}$±s )"

Group n Pulse rate (bpm) Body temperature (℃) Respiratory rate (bpm) LDH (U/L) Glucose (mmol/L)
Mild hypoalbuminemia 54 118.00±17.35 37.93±0.95 31.34±8.04 634.08±327.00 15.33±7.08
Severe hypoalbuminemia 84 134.67±29.14** 38.77±0.98 36.27±8.39** 845.06±608.60* 14.94±7.45
Group n Ca2+ (mmol/L) Triglyceride (mmol/L) Ranson score APACHEⅡ score Balthazar CT score
Mild hypoalbuminemia 54 1.74±0.35 3.79±4.06 4.77±1.62 9.84±4.20 6.23±2.19
Severe hypoalbuminemia 84 1.50±0.46** 3.25±3.74 5.10±1.81 11.71±5.37* 7.08±2.50
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