Schneider Alexander, Löhr J Matthias, Singer Manfred V
Department of Medicine II, Medical Faculty at Mannheim, University of Heidelberg, Theodor Kutzer Ufer 1-3, D-68135, Mannheim, Germany.
J Gastroenterol. 2007 Feb;42(2):101-19. doi: 10.1007/s00535-006-1945-4. Epub 2007 Mar 12.
Several classification systems of chronic pancreatitis have been proposed to provide a basis for treatment and research. All of these previous classifications were designed at the height of pancreatic research of their respective times; thus, each represented the most current knowledge available to pancreatologists at the time. However, none of these classifications provide simultaneously a simple standardized system for the clinical classification of chronic pancreatitis according to etiology, clinical stage, and severity of the disease, nor are they consistently useful for directing clinical practice and comparing interinstitutional data. Thus, we aimed to develop a new classification system of chronic pancreatitis to provide a framework for studying the interaction of various risk factors on the course of the disease.
We reviewed the literature on the clinical course of all different forms of chronic pancreatitis, and we reviewed all previous classification systems of the disease. This approach provided a basis for the development of a new and unifying classification of chronic pancreatitis.
We established the M-ANNHEIM multiple risk factor classification system based on the current knowledge of acute and chronic pancreatitis. This classification allows patients to be categorized according to the etiology, clinical stage, and severity of their disease. The severity of pancreatic inflammation was assessed using a scoring system that takes into account the clinical symptoms and treatment options of chronic pancreatitis. Finally, four hypothetical patients were categorized according to the M-ANNHEIM classification system to provide examples of its applicability in clinical practice.
The M-ANNHEIM multiple risk factor classification system is simple, objective, accurate, and relatively noninvasive, and it incorporates etiology, different stages of the disease, and various degrees of clinical severity. This new classification system will be helpful for investigating the impact and interaction of various risk factors on the course of the disease and will facilitate the comparison and combination of interinstitutional data.
已提出多种慢性胰腺炎分类系统，为治疗和研究提供依据。所有这些先前的分类都是在各自时代胰腺研究的鼎盛时期设计的；因此，每种分类都代表了当时胰腺病学家所掌握的最新知识。然而，这些分类均未同时提供一个简单的标准化系统，用于根据病因、临床分期和疾病严重程度对慢性胰腺炎进行临床分类，也并非始终有助于指导临床实践和比较机构间数据。因此，我们旨在开发一种新的慢性胰腺炎分类系统，为研究各种风险因素对疾病进程的相互作用提供一个框架。
我们回顾了关于所有不同形式慢性胰腺炎临床病程的文献，并回顾了该疾病先前的所有分类系统。这种方法为开发一种新的统一的慢性胰腺炎分类提供了基础。
我们基于对急性和慢性胰腺炎的现有认识，建立了M-安纳海姆多危险因素分类系统。该分类允许根据患者的病因、临床分期和疾病严重程度进行分类。使用一个考虑慢性胰腺炎临床症状和治疗选择的评分系统评估胰腺炎症的严重程度。最后，根据M-安纳海姆分类系统对四名假设患者进行分类，以举例说明其在临床实践中的适用性。
M-安纳海姆多危险因素分类系统简单、客观、准确且相对无创，它纳入了病因、疾病的不同阶段以及临床严重程度的不同程度。这种新的分类系统将有助于研究各种风险因素对疾病进程的影响和相互作用，并将促进机构间数据的比较和整合。
