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[慢性酒精中毒患者肝脏与胰腺疾病并存。是罕见情况还是常见情况?]

[Coexistence of hepatic and pancreatic disease in the chronic alcoholic. Unusual or frequent situation?].

作者信息

Sofia C, Cadime A, Cotrim I, Souto P, Freitas D, Monteiro G

机构信息

Serviço de Gastrenterologia, Hospitais da Universidade de Coimbra.

出版信息

Acta Med Port. 1992 May;5(5):235-8.

PMID:1502934
Abstract

In all that has been written there is still some controversy about the importance of the simultaneous pathologycal involvement (functional and/or morphologic) of the pancreas and liver on the same alcoholic patient. Thus, and with the intention of reaching an agreement on the matter, we studied on one hand, on a functional basis, the exocrine pancreas in a group of alcoholic cirrhotics (n = 75) and, on the other, we analysed on a triple perspective--clinical, biological and anatomic-pathological--the pathological involvement of the liver in a series of cases (n = 20) with chronic calcifying pancreatitis. In such case, we verified that, essentially, the secretory capacity of the pancreas had diminished in 17.3% of the cirrhotic cases, while on the other hand, the clinical-laboratorial and anatomic-pathological analysis of liver on pancreatic patients showed clinical-biological suspicion of alcoholic hepatic disease, serious lesions considered pre-cirrhotic and established cirrhosis, respectively in 56.2%, 12.5% and 6.2% of the cases. We conclude that, although the idea of rarity in associating hepatic cirrhosis with chronic pancreatitis, came through on the clinical-symptomatological observation plan, certain investigations of functional and/or histopathological nature, run by us on alcoholic patients, proved to suffer from these affections, permitted us to indicate that the coexistence of pathological involvement of these two organs should not be underestimated.

摘要

在所有已撰写的内容中,对于同一酒精性肝病患者胰腺和肝脏同时出现病理改变(功能和/或形态学)的重要性仍存在一些争议。因此,为了就此事达成共识,一方面,我们基于功能对一组酒精性肝硬化患者(n = 75)的外分泌胰腺进行了研究;另一方面,我们从临床、生物学和解剖病理学三个角度,对一系列慢性钙化性胰腺炎病例(n = 20)中肝脏的病理改变进行了分析。在这种情况下,我们证实,本质上,17.3%的肝硬化病例中胰腺的分泌能力有所下降,而另一方面,对胰腺疾病患者肝脏的临床实验室和解剖病理学分析显示,在56.2%、12.5%和6.2%的病例中,分别存在酒精性肝病的临床生物学疑似情况、被认为是肝硬化前期的严重病变以及确诊的肝硬化。我们得出结论,虽然从临床症状观察的角度来看,肝硬化与慢性胰腺炎相关的情况较为罕见,但我们对酒精性肝病患者进行的某些功能和/或组织病理学性质的研究表明,患有这些疾病的患者中,这两个器官病理改变的共存不应被低估。

相似文献

1
[Coexistence of hepatic and pancreatic disease in the chronic alcoholic. Unusual or frequent situation?].[慢性酒精中毒患者肝脏与胰腺疾病并存。是罕见情况还是常见情况?]
Acta Med Port. 1992 May;5(5):235-8.
2
Association of chronic alcoholic liver and pancreatic disease: a prospective study.慢性酒精性肝病与胰腺疾病的关联:一项前瞻性研究。
Am J Gastroenterol. 1985 Dec;80(12):998-1003.
3
[Concomitance of hepatic lesions with chronic calcifying pancreatitis in the alcoholic. Study of 60 cases].[酒精性慢性钙化性胰腺炎合并肝脏病变。60例研究]
Arq Gastroenterol. 1983 Jul-Sep;20(3):103-7.
4
Diffuse fibrosis of the pancreas: a peculiar pattern of pancreatitis in alcoholic cirrhosis.
Gastroenterol Clin Biol. 1989 Jun;13(6-7):579-84.
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Exocrine pancreatic function in chronic liver diseases.慢性肝病中的胰腺外分泌功能
Am J Gastroenterol. 1991 Feb;86(2):201-4.
6
Factors predictive of liver histopathological appearance in chronic alcoholic pancreatitis with common bile duct stenosis and increased serum alkaline phosphatase.慢性酒精性胰腺炎合并胆总管狭窄及血清碱性磷酸酶升高时肝脏组织病理学表现的预测因素。
Hepatology. 1993 Nov;18(5):1078-81.
7
Pancreatic fibrosis in patients with chronic alcohol abuse: correlation with alcoholic pancreatitis.慢性酒精滥用患者的胰腺纤维化:与酒精性胰腺炎的相关性
Am J Gastroenterol. 1994 Nov;89(11):2060-2.
8
[Evaluation of exocrine pancreatic insufficiency in cirrhotic patients,using the fecal chymotrypsin test].
Clin Ter. 1994 Jun;144(6):501-9.
9
Acute (nonprogressive) alcoholic pancreatitis: prospective longitudinal study of 144 patients with recurrent alcoholic pancreatitis.急性(非进行性)酒精性胰腺炎:对144例复发性酒精性胰腺炎患者的前瞻性纵向研究。
Pancreas. 1986;1(3):195-203.
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[Influence of bouts of acute pancreatitis on the course of chronic alcoholic pancreatitis in man].[急性胰腺炎发作对人类慢性酒精性胰腺炎病程的影响]
Gastroenterol Clin Biol. 1989 Dec;13(12):1050-4.

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