Clinical efficacy analysis of plasmapheresis for predicted severe hypertriglyceridemia-associated acute pancreatitis
10.3760/cma.j.cn115667-20241029-00177
- VernacularTitle:血浆置换在预测为重症高三酰甘油血症性急性胰腺炎患者中的疗效分析
- Author:
Lanting WANG
1
;
Jing ZHOU
;
Yuan YUAN
;
Weijie YAO
;
Guixian LUO
;
Yizhen XU
;
Weijian LI
;
Longxiang CAO
;
Zhihui TONG
;
Yuxiu LIU
;
Lu KE
;
Weiqin LI
Author Information
1. 中国人民解放军东部战区总医院（南京大学医学院附属金陵医院）重症医学科，南京 210002
- Publication Type:Journal Article
- Keywords:
Hypertriglyceridemia;
Pancreatitis;
Plasma exchange;
Multiple organ failure
- From:
Chinese Journal of Pancreatology
2025;25(1):32-37
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the impact of plasmapheresis therapy on the clinical efficacy in predicted severe hypertriglyceridemia-associated acute pancreatitis (HTG-AP) patients.Methods:The clinical data of 500 HTG-AP patients admitted to 36 medical centers across China in the Chinese Acute Pancreatitis Clinical Trials Group-PERFORM database from November 2020 to June 2023 were retrospectively analyzed. Besides the inclusion and exclusion criteria from PERFORM study, patients who had acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score ≥8 or CRP>150 mg/L on admission were included in the final analyses ( n=189). Patients were categorized into the plasmapheresis group ( n=51) and the routine treatment group ( n=138) according to the triglyceride-lowering therapies they received. General data, laboratory findings, AP severity, and clinical outcomes were recorded. Results:Patients undergoing plasmapheresis had higher initial triglyceride levels, APACHEⅡ score, SOFA score, and more organ failure than those receiving routine medical treatment. Results of multivariable logistic regression models showed that the plasmapheresis group, as compared to the routine treatment group, was neither associated with decreased risk of persistent organ failure within 14 days [54.9% (28/51) vs 37.7% (52/138), OR=0.89, 95% CI 0.36-2.21, P=0.810], nor with reduced incidence of organ failure on day 7 [17.7% (9/51) vs 15.9% (22/138), OR=0.60, 95% CI 0.19-1.88, P=0.378]. There was no significant difference on the dynamic changes of serum triglyceride within the first three days of admission ( P=0.108). Conclusions:Early plasmapheresis is not associated with reduced incidence of persistent organ failure in predicted severe HTG-AP patients.
