Gullo Lucio, Migliori Marina, Oláh Attila, Farkas Gyula, Levy Philippe, Arvanitakis Constantine, Lankisch Paul, Beger Hans
Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy.
Pancreas. 2002 Apr;24(3):223-7. doi: 10.1097/00006676-200204000-00003.
In recent years, many advances have been made in the diagnosis and treatment of acute pancreatitis that have lead to a significant reduction in both morbidity and mortality; however, knowledge of the etiology and of the relation between etiology and mortality is far from complete.
To obtain a more comprehensive view of the etiology and mortality of acute pancreatitis in Europe than has been given by previous single-center studies.
The study comprised 1,068 patients in five European countries who were admitted to hospitals for acute pancreatitis from January 1990 to December 1994. Data for each patient were collected on a standardized form.
Of the 1,068 patients (692 men, 376 women; mean age, 52.8 years; range, 10-95 years), 589 had edematous pancreatitis, and 479 the necrotic form. Cholelithiasis (37.1%) and alcohol (41.0%) were the most frequent etiologic factors. In Germany, cholelithiasis and alcohol occurred with similar frequency (34.9 and 37.9%, respectively); in Hungary, alcohol predominates over cholelithiasis (60.7 vs. 24.0%); in France, a small predominance of alcohol was seen (38.5 vs. 24.6%); and in Greece and Italy, there was a clear predominance of cholelithiasis over alcohol (71.4 vs. 6.0% and 60.3 vs. 13.2%, respectively). The differences in the frequency of cholelithiasis and alcohol between Greece and Italy and the other countries were statistically significant (p < 0.01). Eighty-three patients (7.8%) died of acute pancreatitis; 77 (16.1%) had necrotic disease and 6 (1.0%) edematous. There was no statistically significant difference in mortality among the etiologic groups, and no relation was found between mortality and age.
Both cholelithiasis and alcohol were main etiologic factors in the more northern countries studied, whereas cholelithiasis alone predominated in the more southern ones. Mortality was high for necrotic pancreatitis; it was similar among the various etiologic groups, and there was no relationship between mortality and age.
近年来，急性胰腺炎的诊断和治疗取得了许多进展，发病率和死亡率均显著降低；然而，关于病因以及病因与死亡率之间的关系，我们的了解还远远不够全面。
旨在比以往单中心研究更全面地了解欧洲急性胰腺炎的病因和死亡率情况。
该研究纳入了1990年1月至1994年12月期间在欧洲五个国家因急性胰腺炎入院的1068例患者。每位患者的数据通过标准化表格收集。
1068例患者（692例男性，376例女性；平均年龄52.8岁；年龄范围10 - 95岁）中，589例为水肿性胰腺炎，479例为坏死性胰腺炎。胆结石（37.1%）和酒精（41.0%）是最常见的病因。在德国，胆结石和酒精的发生率相近（分别为34.9%和37.9%）；在匈牙利，酒精是主要病因，超过胆结石（60.7%对24.0%）；在法国，酒精略占优势（38.5%对24.6%）；在希腊和意大利，胆结石明显多于酒精（分别为71.4%对6.0%和60.3%对13.2%）。希腊和意大利与其他国家在胆结石和酒精发生率上的差异具有统计学意义（p < 0.01）。83例患者（7.8%）死于急性胰腺炎；77例（16.1%）患有坏死性疾病，6例（1.0%）患有水肿性疾病。各病因组之间的死亡率无统计学显著差异，且未发现死亡率与年龄之间存在关联。
在所研究的欧洲北部国家，胆结石和酒精都是主要病因，而在南部国家，仅胆结石占主导地位。坏死性胰腺炎的死亡率较高；各病因组的死亡率相似，且死亡率与年龄之间无关联。
