Sofia C, Cadime A, Cotrim I, Souto P, Freitas D, Monteiro G
Serviço de Gastrenterologia, Hospitais da Universidade de Coimbra.
Acta Med Port. 1992 May;5(5):235-8.
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.
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。