The changes and significance of multiple organ functions in acute pancreatitis patients under hypoxic condition on plateau

Abstract

To explore characteristics of the pathogenesis and progression of the acute pancreatitis (AP) in high altitude and the relationship between AP and plateau erythrocythemia. Retrospective analysis of the clinical data of AP was conducted for 103 inpatients who were admitted during 2003 and 2005 to the People's Hospital of Qinghai Province, including 12 cases of AP complicated with plateau erythrocythemia and 91 cases of AP no complicating plateau erythrocythemia. The patients were divided into a group of 57 cases living in high altitude (>3 000 m) and 46 patients in lower altitude group (<2 200 m). Clinical data of the patients were collected at admission, and liver, kidney and lung functions were determined for all patients. Alanine aminotransferase (ALT) and creatinine (Cr) were significantly higher in AP complicating plateau erythrocythemia compared with AP patients without complicating plateau erythrocythemia [ALT: (160.70 + or - 19.14) U/L vs. (78.00 + or - 14.96) U/L, Cr: (135.45 + or - 11.99) micromol/L vs. (91.42 + or - 17.08) micromol/L, both P<0.05]. Arterial partial pressure of oxygen (PaO(2)) and arterial oxygen saturation (SaO(2)) were significantly lower in AP with complication of plateau erythrocythemia than in AP without complicating plateau erythrocythemia [PaO(2): (45.10 + or - 0.40) mm Hg vs. (65.48 + or - 1.36) mm Hg, 1 mm Hg=0.133 kPa, SaO(2): 0.851 + or - 0.004 vs. 0.940 + or - 0.009, both P<0.05]. There was no difference in aspartate aminotransferase (AST), blood urea nitrogen (BUN) and arterial partial pressure of carbon dioxide (PaCO(2)), however, their levels were higher in plateau erythrocythemia cases than those without plateau erythrocythemia [AST: (87.35 + or - 8.10) U/L vs. (83.00 + or - 18.61) U/L, BUN:(10.90 + or - 0.97) mmol/L vs. (7.37 + or - 0.98) mmol/L, PaCO(2): (33.20 + or - 0.31) mm Hg vs. (25.32 + or - 1.14) mm Hg , all P>0.05]. ALT and Cr were significantly higher in high altitude cases than those in lower altitude cases [ALT: (126.92 + or - 15.46) U/L vs. (86.00 + or - 10.23) U/L, Cr:(126.10 + or - 10.01)micromol/L vs. (101.84 + or - 5.46) micromol/L, both P<0.05]. There was no difference in AST, BUN and PaCO(2), however, the values were slightly higher in high altitude cases compared with lower altitude cases [AST: (98.70 + or - 8.10) U/L vs. (93.14 + or - 21.46) U/L, BUN: (8.15 + or - 1.00) mmol/L vs. (5.86 + or - 0.40) mmol/L, PaCO(2): (32.32 + or - 1.01) mm Hg vs. (30.12 + or - 2.76) mm Hg, all P>0.05]. There was no difference in PaO(2) and SaO(2), however, it was slightly lower in high altitude cases than lower altitude cases [PaO(2): (58.80 + or - 1.20) mm Hg vs. (66.86 + or - 3.20) mm Hg, SaO(2): 0.910 + or - 0.011 vs. 0.930 + or - 0.008, both P>0.05]. The results showed that the deterioration of hepatic, kidney and lung function in AP patients living in the plateau was related to high altitude and erythrocythemia.