Lévy Philippe, Barthet Marc, Mollard Bruno Richard, Amouretti Michel, Marion-Audibert Anne-Marie, Dyard François
Pôle des Maladies de l'Appareil Digestif, Service de Gastroentérologie-Pancréatologie, APHP, Hôpital Beaujon, Clichy.
Gastroenterol Clin Biol. 2006 Jun-Jul;30(6-7):838-44. doi: 10.1016/s0399-8320(06)73330-9.
Incidence and prevalence of chronic pancreatitis (CP) are poorly known and prospective nationwide epidemiologic estimation has never been performed.
To estimate prospectively national incidence and prevalence of patients attending gastroenterologists for CP in France.
Study was proposed to all of the French gastroenterologists (N=3215) of whom 753 accepted to participate (24% private, 40% hospital and 36% both). Were included all patients suffering from proved or suspected CP, from 04-2003 to 07-2003. Certain diagnostic criteria were pancreatic calcifications, ductal or histological abnormalities. For all of non-responder gastroenterologists, a tracking system was used (mail or by phone).
A total of 456 gastroenterologists returned at least 1 case on 1748 patients. Median patient age was 51 years; sex-ratio was 5.07. Median duration between the first CP sign and the inclusion was 41 months. CP cause was alcoholism (84%), hereditary (1%), cystic fibrosis (1%), idiopathic (9%), other (6%). CP diagnosis was certain in 77%: calcifications (85%), ductal abnormalities (57%), and histology (8%). CP symptoms were: chronic abdominal pain (53%), acute pancreatitis episodes (67%), pseudocysts (40%), bi-liary tract compression (21%), diabetes mellitus (32%), pancreatic exocrine insufficiency (36%). Maximal annual incidence was 4,646 (crude annual incidence: 7.7 per 100,000; 12.9 in male; 2.6 in female) and prevalence was 15,832 cases (crude prevalence: 26.4 per 100,000; 43.8 in male; 9.0 in female).
New CP patients attending gastroenterologists are about 5,000 a year. CP prevalence is about 16,000 patients (in France: 60,400,000 inhabitants). Frequency of main complications is close to hospital series, confirming that results issued from these centers are not or a few biased.
慢性胰腺炎(CP)的发病率和患病率尚不清楚,且从未进行过全国性的前瞻性流行病学评估。
前瞻性评估法国因慢性胰腺炎就诊于胃肠病专家的患者的全国发病率和患病率。
向所有法国胃肠病专家(共3215人)发起研究,其中753人同意参与(24%为私人执业,40%为医院执业,36%两者皆有)。纳入2003年4月至2003年7月间所有确诊或疑似慢性胰腺炎的患者。某些诊断标准为胰腺钙化、导管或组织学异常。对于所有未回复的胃肠病专家,采用追踪系统(邮件或电话)。
共有456名胃肠病专家上报了1748例患者中的至少1例。患者年龄中位数为51岁;男女比例为5.07。从首次出现慢性胰腺炎症状到纳入研究的时间中位数为41个月。慢性胰腺炎病因包括:酒精中毒(84%)、遗传性(1%)、囊性纤维化(1%)、特发性(9%)、其他(6%)。77%的患者确诊为慢性胰腺炎:钙化(85%)、导管异常(57%)、组织学确诊(8%)。慢性胰腺炎症状包括:慢性腹痛(53%)、急性胰腺炎发作(67%)、假性囊肿(40%)、胆道压迫(21%)、糖尿病(32%)、胰腺外分泌功能不全(36%)。最高年发病率为4646例(粗年发病率:每10万人中7.7例;男性为12.9例;女性为2.6例),患病率为15832例(粗患病率:每10万人中26.4例;男性为43.8例;女性为9.0例)。
每年因慢性胰腺炎就诊于胃肠病专家的新患者约为5000例。慢性胰腺炎患病率约为16000例患者(法国人口6040万)。主要并发症的发生率与医院系列报道相近,证实这些中心得出的结果无偏差或仅有轻微偏差。