Clinical study of double filtration plasmapheresis in the treatment of hyperlipidemia pancreatitis

doi:10.3969/j.issn.1006-7795.2021.06.007

Abstract

Abstract: Objective To verify the clinical significance of double filtration plasmapheresis (DFPP) in the treatment of hypertriglyceridemia acute pancreatitis (HTG-AP). Methods A retrospective case-control research methods was used to collect HTG-AP patients who were admitted to the Department of Critical Care Medicine, Beijing Luhe Hospital, Capital Medical University for the first time. The DFPP group included 45 HTG-AP patients admitted in from September 2017 to March 2021 and treated with DFPP to reduce triglyceride (TG). The insulin group collected 24 HTG-AP patients admitted in from September 2015 to August 2017, who were treated with insulin and glucose infusion to control TG. Both groups were given standard treatments such as fasting, gastric acid and pancreatic enzyme secretion suppression, and nutritional support. The demographic characteristics, biochemical blood indicators, inflammatory markers, incidence of adverse events, length of stay in intensive care unit (ICU) and hospital stay of the two groups of cases were collected. Results There was no significant difference between the two groups in terms of gender, age, and severity of HTG-AP (P>0.05). The DFPP group was significantly better than the insulin group in reducing the time required for TG, staying time in ICU, and length of hospital stay in the insulin group (P＜0.05). The time required for TG to drop below 3.71 mmol/L in the test group was significantly less than that in the insulin group (6.7±3.3) h and (44.1±11.6) h, respectively (P<0.01). The 72-hour relief rate of clinical symptoms such as abdominal pain and bloating in the test group was significantly higher than that in the insulin group (P<0.05). With regard to the speed and amplitude of decline, the peripheral blood leukocytes, C-reactive protein, interleukin 6, interleukin 8, tumor necrosis factor-alpha and other inflammatory indicators in the DFPP group are significantly better than that in the insulin group (P<0.01). During the treatment, the vital signs of the patients in both groups were stable and well-tolerated, and there were no adverse events such as allergic reactions and bleeding, suggesting the treatment safety was good. Conclusion The results showed that the DFPP is the fastest and most effective treatment for reducing TG, and its efficacy in severe HTG-AP depends on its early implementation. For large medical institutions with mature operating technology, we believe that it should be beneficial to use DFPP method to treat severe HPG-AP as early as possible with a view to blocking the possible malignant process of HPG-AP as soon as possible.

Key words: hypertriglyceridemia pancreatitis, hypertriglyceridemia, double filtration plasmapheresis

CLC Number:

R576

Liu Li, Wang Guan, Zhao Xinyu, Liu Jingyuan, Ji Yu, Liu Yong, Han Wei, Weng Yibing, Li Ang. Clinical study of double filtration plasmapheresis in the treatment of hyperlipidemia pancreatitis[J]. Journal of Capital Medical University, 2021, 42(6): 943-949.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2021.06.007

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2021/V42/I6/943

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