Okazaki Kazuichi
Department of Gastroenterology and Endoscopic Medicine, Kyoto University Hospital, Shogoin-Kawaracho, Sakyo, Kyoto, 606-8507, Japan.
Curr Treat Options Gastroenterol. 2001 Oct;4(5):369-375. doi: 10.1007/s11938-001-0002-x.
The treatment of patients with autoimmune pancreatitis poses a challenge to the clinician. Prednisone, in an initial dosage of 30 to 40 mg/d, is used in patients with moderate abdominal and back pain, obstructive jaundice, or sclerosing cholangitis. Antacid or anticholinergic agents may be used to minimize stimulation of pancreatic exocrine function. Patients with quiescent disease may not need pharmacologic medication. In patients with complications such as obstructive jaundice and infection, biliary drainage and administration of antibiotics are recommended prior to steroid therapy. Steroid therapy occasionally ameliorates diabetes mellitus associated with autoimmune pancreatitis.
自身免疫性胰腺炎患者的治疗给临床医生带来了挑战。对于有中度腹痛、背痛、梗阻性黄疸或硬化性胆管炎的患者,初始剂量为30至40mg/d的泼尼松。可使用抗酸剂或抗胆碱能药物以尽量减少对胰腺外分泌功能的刺激。病情静止的患者可能不需要药物治疗。对于有梗阻性黄疸和感染等并发症的患者,建议在使用类固醇治疗之前进行胆道引流并给予抗生素。类固醇治疗偶尔可改善与自身免疫性胰腺炎相关的糖尿病。