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[经内镜逆行胰胆管造影诊断的糖尿病患者胆道和胰腺的解剖学变化]

[Anatomic changes in the biliary tract and pancreas in patients with diabetes mellitus diagnosed by endoscopic retrograde cholangiopancreatography].

作者信息

Szałaj W, Stasiewicz J, Skwarski L, Janke A, Romatowski J

机构信息

Oddziału Gastroenterologii Wojewódzkiego Szpitala Zespolonego im. Jedrzeja Sniadeckiego, Białymstoku.

出版信息

Pol Tyg Lek. 1992;47(3-4):71-4.

PMID:1437789
Abstract

Structural changes in both biliary tract and pancreas have been assessed with endoscopic retrograde cholangiopancreatography in 100 diabetic patients divided into subgroups depending on the type of diabetes mellitus, i.e. type I, type II and III-pancreatic. Control group included 100 randomly selected patients without diabetes mellitus in whom endoscopic retrograde cholangiopancreatography has been performed for various indications. Structural changes in the biliary tract and pancreas have been more frequent in diabetic patients than in the control group (47 and 75% vs 32 and 30%, respectively). Cholelithiasis has been noted in 27.8% of patients with type II diabetes mellitus and in 11.3% of patients with type I diabetes mellitus; obesity has been found in 57 and 12% of patients, respectively. Other biliary tract disorders, mainly in the form of segmental stenosis or dilatation of the common bile duct, have been more frequent in patients with type II diabetes mellitus. Pancreatic disorders, assessed with the aid of Cambridge classification, have been noted in all patients with pancreatic diabetes and in 80.7% of patients with diabetes mellitus type I. Incidence of so-called doubtful and mild disorders has been more frequent (22.2 and 24.1%, respectively) in patients with diabetes mellitus type II whereas "moderate" and "severe" disorders have been significantly less frequent (7.4 and 1.9% of patients). The results indicate, that endoscopic retrograde cholangiopancreatography is useful in the assessment of bile ducts structure and pancreatic exocrine activity in diabetic patients in whom disorders are more frequent.

摘要

采用内镜逆行胰胆管造影术对100例糖尿病患者的胆道和胰腺结构变化进行了评估,这些患者根据糖尿病类型分为亚组,即I型、II型和III型(胰腺型)糖尿病。对照组包括100例随机选取的无糖尿病患者,他们因各种适应证接受了内镜逆行胰胆管造影术。糖尿病患者胆道和胰腺的结构变化比对照组更常见(分别为47%和75%,而对照组为32%和30%)。II型糖尿病患者中27.8%有胆石症,I型糖尿病患者中11.3%有胆石症;肥胖分别在57%和12%的患者中发现。其他胆道疾病,主要表现为胆总管节段性狭窄或扩张,在II型糖尿病患者中更常见。借助剑桥分类法评估的胰腺疾病,在所有胰腺型糖尿病患者以及80.7%的I型糖尿病患者中都有发现。所谓可疑和轻度疾病的发生率在II型糖尿病患者中更高(分别为22.2%和24.1%),而“中度”和“重度”疾病明显较少见(分别为患者的7.4%和1.9%)。结果表明,内镜逆行胰胆管造影术有助于评估糖尿病患者的胆管结构和胰腺外分泌活动,这些患者的疾病更为常见。

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