目的    探讨重症急性胰腺炎（SAP）的病因。方法    回顾性分析2000年1月至2011年12月12年间北京协和医院住院治疗的337例SAP病人的临床资料。结果    337例病人胆源性SAP占46.9%，特发性占19.8%、高脂血症性占16.3%、酒精性占10.4%。高脂血症性SAP有上升趋势（10.9% vs. 20.0%，P=0.027）。酒精性SAP中男性比例明显高于女性（15.3% vs. 0.9%，P<0.001）。老年SAP病人中胆源性比例高于非老年（74.1% vs. 32.6%，P<0.001），高脂血症性和酒精性则以非老年为高（P<0.001）。结论    胆源性是SAP最常见病因，在老年SAP中其比例更高；高脂血症性SAP呈上升趋势；酒精性SAP多见于男性；高脂血症性和酒精性SAP多见于中青年病人。

Etiology of severe acute pancreatitis: an analysis of 337 cases        LU Bo，YANG Hong，QIAN Jia-ming. Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730,China
Corresponding author: QIAN Jia-ming, E-mail: qjiaming57@gmail.com
Abstract    Objective    To analyze the etiology of severe acute pancreatitis (SAP). Methods    The clinical data of 337 cases of SAP hospitalized between January 2000 and December 2011 at Peking Union Medical College（PUMC）Hospital were analyzed retrospectively. Results    Biliary SAP, idiopathic SAP, hyperlipemic SAP and alcoholic SAP was accounted for (46.9%), (19.8%), (16.3%) and (10.4%) respectively. There was an ascending trend in hyperlipemic SAP（10.9% vs. 20.0%, P=0.027）. Male was significantly more than female in alcoholic SAP (15.3% vs. 0.9%, P<0.001). The proportion of biliary SAP in the elderly was higher than that in the non-elderly（74.1% vs. 32.6%, P<0.001). The proportions of hyperlipemic and alcoholic SAP in the non-elderly were higher than those in the elderly（P<0.001）. Conclusion    Biliary factor is the most common etiology of SAP. The proportion of biliary SAP in the elderly is higher than that in non-elderly. With time changed, there is an ascending trend in hyperlipemic SAP. Alcoholic SAP is mainly in male. The cases of hyperlipemic and alcoholic SAP are mainly in the non-elderly.