Lesur G, Levy P, Bernades P
Service de Gastroentérologie, Hôpital Beaujon, Clichy.
Gastroenterol Clin Biol. 1991;15(8-9):600-3.
The aims of this study were to assess the prevalence of duodenal ulcer during chronic pancreatitis and the relationship between the occurrence of duodenal ulcer and the course of chronic pancreatitis. The population consisted of 264 men with chronic pancreatitis, 94 percent of which were of alcoholic origin. Duodenal ulcer occurred in 37 patients (14 percent). Fifteen patients with gastric or anastomotic ulcer were excluded. The 37 patients with duodenal ulcer were compared with 212 patients without ulcer. There was no significant difference between the two groups as regards the course of chronic pancreatitis except for insulin-dependent diabetes mellitus which was significantly more frequent in patients without duodenal ulcer (P less than 0.05). Eight patients with duodenal ulcer died but the cause of death was not related to their ulcer. All patients with duodenal ulcer and 92 percent of those without were smokers (not significant). Duodenal ulcer occurred in 25/37 patients (68 percent) before the clinical onset of chronic pancreatitis. The risk of duodenal ulcer occurrence was constant in 17-65 year old patients and independent of the time of chronic pancreatitis onset. We concluded that in men with chronic pancreatitis: a) prevalence of duodenal ulcer is 14 percent; b) duodenal ulcer occurred most often before clinical onset of chronic pancreatitis; c) duodenal ulcer occurs independently of the course of pancreatitis which cannot account for its high prevalence. Smoking may be a promoting factor.
本研究的目的是评估慢性胰腺炎患者十二指肠溃疡的患病率，以及十二指肠溃疡的发生与慢性胰腺炎病程之间的关系。研究对象为264名患有慢性胰腺炎的男性，其中94%由酒精所致。37名患者（14%）发生了十二指肠溃疡。15名患有胃溃疡或吻合口溃疡的患者被排除。将37名十二指肠溃疡患者与212名无溃疡患者进行比较。除胰岛素依赖型糖尿病在无十二指肠溃疡的患者中明显更常见外（P<0.05），两组在慢性胰腺炎病程方面无显著差异。8名十二指肠溃疡患者死亡，但死亡原因与溃疡无关。所有十二指肠溃疡患者及92%无溃疡患者均为吸烟者（无显著差异）。25/37例患者（68%）的十二指肠溃疡发生在慢性胰腺炎临床发作之前。十二指肠溃疡发生风险在17至65岁患者中恒定，且与慢性胰腺炎发病时间无关。我们得出结论，在患有慢性胰腺炎的男性中：a）十二指肠溃疡患病率为14%；b）十二指肠溃疡最常发生在慢性胰腺炎临床发作之前；c）十二指肠溃疡的发生与胰腺炎病程无关，胰腺炎病程无法解释其高患病率。吸烟可能是一个促进因素。
