Acute pancreatitis is a common holiday disease in general surgery, more critical and serious, most of them can recover by non-surgical treatment, some patients have rapid disease progression, rapid exacerbation, and even multi-organ dysfunction within 72 hours of onset, handing over the food stamps. So how to effectively prevent the recurrence of acute pancreatitis is particularly important.
The common causes of acute pancreatitis are: gallstones, alcoholism or overeating, and other causes. For patients suffering from acute pancreatitis, the soreness of abdominal pain is an unspeakable experience, and most patients follow the advice of their doctors to reduce the triggers of recurrence. However, there is a type of acute pancreatitis called hyperlipidemic pancreatitis, the onset of which is sometimes not so well controlled. This article focuses on knowledge about hyperlipidemic acute pancreatitis, especially prevention methods.
Definition of hyperlipidemic acute pancreatitis.
Acute pancreatitis with venous celiac blood or blood triglycerides >11.3 mmol/L can be clearly diagnosed and requires a short period of time to lower triglyceride levels as much as possible to below 5.65 mmol/L.
Pathogenesis.
There is no clear cut-off value for how high triglycerides (TG) will cause pancreatitis, and it is generally believed that the higher the level the greater the risk of causing pancreatitis. elevated TG, especially when TG >11.3 mmol/L, greatly increases the risk of inducing the development of acute pancreatitis. The following pathogenic mechanisms play a very important role in the development of hyperlipidemic pancreatitis.
1. Free fatty acid mechanism
Excess triglycerides are hydrolyzed into FFA by pancreatic lipase released into the capillary bed of the pancreas. The large amount of FFA production exceeds the binding capacity of albumin, resulting in excess FFA, which in turn leads to swelling and deformation of cells and even organelles and increased permeability, causing damage to pancreatic alveolar cells and capillary endothelial cells.
2.Microcirculatory mechanism
Pancreatic lobules are highly susceptible to ischemic necrosis due to microcirculatory disorders, which forms the anatomical basis for its occurrence.
3, Calcium overload mechanism
Hyperlipidemia can in turn induce lipid peroxidation of cell membranes and organelle membranes, causing abnormalities in membrane receptor-mediated signal transduction pathways, resulting in increased intracellular Ca2+ concentrations. In the context of hyperlipidemia, a large number of calcium channels are opened, and the calcium overload occurs in the pancreatic alveolar cells, thus aggravating the disease process.
4.Gene mutation
In some patients, primary lipoproteinase deficiency or apolipoproteinase deficiency is the cause.
Etiology classification.
1.Primary: genetic level.
2, secondary: alcoholism diabetes, obesity, high-fat diet, drugs.
3, Mixed: presence of 2 of the above etiologies.
Treatment measures.
1, conventional treatment, and other original types of treatment for acute pancreatitis.
2, lipid-lowering therapy, the use of fibrates will be of drugs such as fenofibrate, gefibrate rapid reduction of triglyceride levels, rapidly reduced as far as possible to below 5.65mmol/L can relieve clinical symptoms.
3, the use of heparin, insulin multi-target therapy. Even blood filtration quickly will be lipid.
How to effectively prevent hyperlipidemic pancreatitis?
Some patients complain that I do not drink, no overeating, light diet, reduce socializing still relapse, life feels gray. In fact, it is not necessary. Doing the following things will reduce the recurrence of the disease. In addition to avoid alcohol abuse and overeating, patients with hyperlipidemic pancreatitis should pay particular attention to the following 4 items.
1. weight control, or weight control.
2, testing lipids, for those whose lipids are higher than 20 mmol/l at the onset of the disease it is recommended to review lipids once every half month and once every 3 months after 3 months, and for triglycerides higher than 4 mmol/l it is recommended to take oral fibrates to lower lipids.
3. avoid eating a diet rich in fats and oils, and avoid all kinds of so-called nourishing soups: lamb soup, chicken soup, fish soup, meat soup, egg yolk, high-fat milk, etc.
4, open your legs, it is recommended to improve your body mass by exercising to control your weight.
Following the advice of your doctor will be one of the best medicines to prevent the recurrence of hyperlipidemic pancreatitis. Treating the disease is a doctor’s duty, and reducing the recurrence of the disease is even more of a duty and mission.