Balakrishnan V, Nair Prem, Radhakrishnan Lakshmi, Narayanan V A
Digestive Diseases Institute, Amrita Institute of Medical Sciences, Cochin, India.
Indian J Gastroenterol. 2006 Mar-Apr;25(2):74-81.
Tropical pancreatitis was described 50 years ago as a disease of the tropical regions, particularly southern India, with young age at onset, malnutrition, rapid progression, severe pancreatic damage with multiple large ductal calculi, and absence of history of alcoholism or biliary tract disease as its hallmarks. Over the years, chronic pancreatitis in southern India has shown a change, with increase in older patients, occurrence of milder disease including milder diabetes, increasing longevity, and increasing association with alcoholism and smoking. This article looks at changes in the disease and in dietetic, environmental and socioeconomic factors over the years, in an attempt to understand the environment-gene interactions in its causation. This analysis shows that tropical pancreatitis may represent one end of the wide spectrum of chronic pancreatitis in the tropics, with alcoholic pancreatitis representing the other extreme.
50年前，热带胰腺炎被描述为一种热带地区的疾病，特别是印度南部，其特征为发病年龄较轻、营养不良、病情进展迅速、胰腺严重受损并伴有多个大导管结石，且无酗酒或胆道疾病史。多年来，印度南部的慢性胰腺炎呈现出变化，老年患者增多，出现了包括轻度糖尿病在内的较轻疾病，寿命延长，与酗酒和吸烟的关联增加。本文探讨了多年来该疾病以及饮食、环境和社会经济因素的变化，试图了解其病因中的环境-基因相互作用。该分析表明，热带胰腺炎可能代表热带地区广泛的慢性胰腺炎谱系的一端，而酒精性胰腺炎代表另一端。
