Bonacini M
Department of Medicine, Truman Medical Center, Kansas City, Missouri.
J Clin Gastroenterol. 1991 Feb;13(1):58-64. doi: 10.1097/00004836-199102000-00013.
Involvement of the pancreas by human immunodeficiency virus (HIV) infection has not been adequately addressed and is the object of this review. I analyzed the English language literature, including single case reports of pancreatic involvement and larger series reporting detailed pathological findings of patients with HIV infection. Nonspecific pathological changes in the pancreas are frequently seen at autopsy of HIV-infected patients, but are not more common than in controls. Several types of infections (mainly cytomegalovirus, Cryptococcus neoformans, and Mycobacteria) and neoplasms (lymphoma and Kaposi's sarcoma) can involve the pancreas because they are usually disseminated. Although the serum amylase may be elevated, the patient remains asymptomatic. Occasional instances of severe and even fatal pancreatitis have been reported with HIV infections and attendant drug toxicity. Pentamidine has a predictable incidence of hypoglycemic episodes and 2',3'-dideoxyinosine provokes pancreatitis in a minority of treated patients. Such drug toxicity seems to deserve greater clinical concern than opportunistic infections or neoplasms.
人类免疫缺陷病毒（HIV）感染对胰腺的影响尚未得到充分研究，本文对此进行综述。我分析了英文文献，包括胰腺受累的单病例报告以及报告HIV感染患者详细病理结果的较大系列研究。在对HIV感染患者进行尸检时，常可见胰腺的非特异性病理改变，但并不比对照组更常见。几种类型的感染（主要是巨细胞病毒、新型隐球菌和分枝杆菌）和肿瘤（淋巴瘤和卡波西肉瘤）可累及胰腺，因为它们通常会播散。虽然血清淀粉酶可能升高，但患者仍无症状。有报道称，HIV感染及伴随的药物毒性偶尔会引发严重甚至致命的胰腺炎。喷他脒引发低血糖发作的发生率是可预测的，而2',3'-双脱氧肌苷在少数接受治疗的患者中会引发胰腺炎。与机会性感染或肿瘤相比，这种药物毒性似乎更值得临床关注。
