Pelli H, Sand J, Laippala P, Nordback I
Dept. of Surgery, Tampere University Hospital, and the School of Medicine and the School of Public Health of Tampere University, Finland.
Scand J Gastroenterol. 2000 May;35(5):552-5. doi: 10.1080/003655200750023840.
Owing to the current lack of long-term follow-up data on the recurrence of alcohol-induced acute pancreatitis (AP), we studied the pattern of recurrence and determined the characteristics of the disease to predict the recurrence.
Between 1972 and 1991, 2678 AP episodes were detected; 1555 were induced by alcohol, and 591 of them were the first episode. During the first alcohol-induced AP 29 patients died and were excluded from further analysis. Of the 562 included, 503 were men, and 59 women. Admission serum tests, severity index, development of complications, intensive care unit and hospital stay, and need for surgery were assessed. Case records were studied. The national database was used to detect admissions to other hospitals.
Overall, 260 (46%) developed recurrent disease. Of the first relapses, 80% developed during 4 years. The recurrence rate has not changed with time. Age less than 45 years increased the risk (odds ratio (OR) = 2.42; 95% confidence interval (CI), 1.30-4.50). The risk factors of the first alcohol-induced AP associated with the development of multi-recurring pancreatitis are age <45 years (OR, 2.42; 95% CI, 1.59-13.0), 0-2 positive Glasgow criteria (OR, 2.45; 95% CI, 1.16-5.19), and arterial oxygen tension >60 mmHg (OR, 9.90; 95% CI, 1.32-74.3).
Fewer than half of the patients develop recurrent alcohol-induced AP. Younger patients are at the highest risk of recurrence. Those whose first alcohol-induced pancreatitis episode was not severe are at a higher risk of developing multi-recurring pancreatitis.
由于目前缺乏酒精性急性胰腺炎（AP）复发的长期随访数据，我们研究了复发模式并确定了疾病特征以预测复发情况。
在1972年至1991年期间，共检测到2678例AP发作；其中1555例由酒精诱发，其中591例为首次发作。在首次酒精性AP发作期间，29例患者死亡并被排除在进一步分析之外。纳入的562例患者中，503例为男性，59例为女性。评估了入院时的血清检查、严重程度指数、并发症的发生情况、重症监护病房和住院时间以及手术需求。研究了病例记录。使用国家数据库检测其他医院的入院情况。
总体而言，260例（46%）出现复发性疾病。首次复发中，80%在4年内发生。复发率并未随时间变化。年龄小于45岁会增加风险（比值比（OR）=2.42；95%置信区间（CI），1.30 - 4.50）。首次酒精性AP发作与多次复发性胰腺炎发生相关的危险因素包括年龄<45岁（OR，2.42；95%CI，1.59 - 13.0）、格拉斯哥标准0 - 2项阳性（OR，2.45；95%CI，1.16 - 5.19）以及动脉血氧分压>60 mmHg（OR，9.90；95%CI，1.32 - 74.3）。
不到一半的患者会发生复发性酒精性AP。年轻患者复发风险最高。首次酒精性胰腺炎发作不严重的患者发生多次复发性胰腺炎的风险更高。
