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中国慢性胰腺炎的患病率及临床特征:一项为期10年的回顾性多中心分析

Prevalence and clinical features of chronic pancreatitis in China: a retrospective multicenter analysis over 10 years.

作者信息

Wang Luo Wei, Li Zhao Shen, Li Shu De, Jin Zhen Dong, Zou Duo Wu, Chen Fu

机构信息

Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.

出版信息

Pancreas. 2009 Apr;38(3):248-54. doi: 10.1097/MPA.0b013e31818f6ac1.

Abstract

OBJECTIVES

A multicenter study was initiated by the Chinese Chronic Pancreatitis Study Group to determine the nature and magnitude of chronic pancreatitis (CP) in China.

METHODS

Twenty-two hospitals representing all 6 urban health care regions in China participated in the study. The survey covered a 10-year period from May 1, 1994, to April 30, 2004. Multiple logistic regression was used for analyses.

RESULTS

The analysis included 2008 patients (64.99% were men, and 35.01% were female; mean age, 48.9 years [SD, 15.0 years]). Chronic pancreatitis prevalence increased yearly from 1996 to 2003: 3.08, 3.91, 5.28, 7.61, 10.43, 11.92, 12.84, and 13.52 per 100,000 inhabitants. Chronic pancreatitis etiologies were alcohol (35.11%), biliary stones (34.36%), hereditary (7.22%), and idiopathic CP (12.90%). Clinical feature were pain (76.25%), maldigestion (36.11%), jaundice (13.40%), and steatorrhea (6.92%). Complications were pseudocyst (26.25%), diabetes (21.61%), bile duct strictures (13.40%), and ascites (1.74%). With regard to the diagnosis, the sensitivity and specificity of endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography were 88% and 93%, and 87% and 93%, respectively. Three hundred ninety-one patients (19.47%) received endoscopic therapy. Surgery was performed in 239 patients (11.90%).

CONCLUSION

In China, the incidence of CP is rising rapidly; alcohol and biliary stones are the main causes. Endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography are highly sensitive and specific diagnostic methods.

摘要

目的

中国慢性胰腺炎研究小组发起了一项多中心研究,以确定中国慢性胰腺炎(CP)的性质和严重程度。

方法

代表中国6个城市医疗保健地区的22家医院参与了该研究。调查涵盖了1994年5月1日至2004年4月30日的10年期间。采用多元逻辑回归进行分析。

结果

分析纳入了2008例患者(男性占64.99%,女性占35.01%;平均年龄48.9岁[标准差15.0岁])。1996年至2003年慢性胰腺炎患病率逐年上升:每10万居民中分别为3.08、3.91、5.28、7.61、10.43、11.92、12.84和13.52例。慢性胰腺炎的病因包括酒精(35.11%)、胆石症(34.36%)、遗传性(7.22%)和特发性慢性胰腺炎(12.90%)。临床特征包括疼痛(76.25%)、消化不良(36.11%)、黄疸(13.40%)和脂肪泻(6.92%)。并发症包括假性囊肿(26.25%)、糖尿病(21.61%)、胆管狭窄(13.40%)和腹水(1.74%)。在诊断方面,内镜超声检查和内镜逆行胰胆管造影的敏感性和特异性分别为88%和93%,以及87%和93%。391例患者(19.47%)接受了内镜治疗。239例患者(11.90%)接受了手术。

结论

在中国,慢性胰腺炎的发病率正在迅速上升;酒精和胆石症是主要病因。内镜超声检查和内镜逆行胰胆管造影是高度敏感和特异的诊断方法。

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