Explore of clinical characteristics and outcomes of acute pancreatitis based on Neijing pulse-respiration ratio
SHI Jia-hua,LI Lan,ZHU Ping
West China Centre of Excellence for Pancreatitis, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital of Sichuan University, Chengdu610041, China
Abstract:
Objective In this study, subgroups of patients with acute pancreatitis (AP) were analyzed based on pulse-respiration ratio, and the clinical outcomes of different subgroups were compared, providing bases for further exploring clinical subtypes of AP. Methods The data of 1636 patients with AP from prospective AP database admitted to West China Hospital of Sichuan University between January 2016 and January 2018 were analyzed. According to the pulse-respiratory ratio, the patients were divided into deficiency of qi (<4, 350 cases), normal (4-5, 1054 cases) and pulse dysphoria (>5, 232 cases ), and clinical outcomes of different subgroups were compared. Results In overall AP patients, the incidence of local complications, persistent organ failure, infectious pancreatic necrosis and length of hospital stay in the pulse dysphoria group were higher than the group of deficiency of qi and normal group. And the difference was statistically significant between the pulse dysphoria group and the normal group (P<0.05). In SAP patients, the incidence of circulatory failure and rate of invasive mechanical ventilation in the pulse dysphoria group were significantly higher than those in normal group (P < 0.05). And the incidence of inotropes usage, infectious pancreatic necrosis and the rate of operation were significantly higher than those in the group of deficiency of qi and the normal group. The difference was statistically significant (P<0.05). The pulse dysphoria group in AP patients showed an increased risk of local complications(OR＝2.35，95%CI=1.76-3.14，P <0.001), acute peripancreatic fluid collection(OR=2.29，95%CI=1.71-3.06，P <0.001), acute necrotic collections(OR＝1.82，95%CI=1.22-2.71，P =0.003), persistent organ failure(OR＝2.34，95%CI=1.66-3.30，P <0.001)and surgery(OR＝2.39，95%CI=1.33-4.27，P=0.003)when compared with the normal group. The group of deficiency of qi also showed an increased risk of persistent organ failure(OR=1.42，95%CI=1.03-1.96，P=0.033). Conclusion AP patients were divided into deficiency of qi , normal and pulse dysphoria according to the Neijing pulse-respiration ratio. The clinical outcomes of the pulse dysphoria subgroup were the most severe of the three.
