Afzelius Pia, Fallentin Eva Marie, Larsen Steen, Møller Søren, Schiødt Morten
Department of Clinical Physiology and Nuclear Medicine, Hvidovre University Hospital, Faculty of Health Sciences, University of Copenhagen, Denmark.
Scand J Gastroenterol. 2010 Jun;45(6):752-8. doi: 10.3109/00365521003642542.
Sjögren's syndrome (SS) is considered to be a universal exocrinopathy most likely based on autoimmune mechanisms. The degree of exocrine involvement in SS with the exception of salivary and lachrymal glands is, however, not yet established.
We therefore examined the morphology, the exocrine and endocrine functions of the pancreas in 12 healthy consecutively included levolunteers with established SS, but without known pancreatic disease, using secretin-stimulated magnetic resonance cholangiopancreatography (MRCP), a Lundh test, oral glucose tolerance test, and blood sampling.
Twenty-five percent of the patients had morphological changes of pancreas as evaluated by secretin-stimulated MRCP, and two patients had chronic pancreatitis-like changes. Four patients had reduced exocrine function of the pancreas with either significantly reduced amylase and/or lipase in the pancreatic juice.
The prevalence of pancreatic dysfunction was increased to 25-33% in the study population which is much higher than in the background population. Thus, pancreatic dysfunction and chronic pancreatitis should be considered in SS.
干燥综合征(SS)很可能基于自身免疫机制被认为是一种全身性外分泌腺病。然而,除唾液腺和泪腺外,SS中其他外分泌腺受累的程度尚未明确。
因此,我们使用促胰液素刺激磁共振胰胆管造影(MRCP)、伦德试验、口服葡萄糖耐量试验及采血,对12例连续纳入的确诊为SS但无已知胰腺疾病的健康志愿者的胰腺形态、外分泌及内分泌功能进行了检查。
通过促胰液素刺激MRCP评估,25%的患者有胰腺形态改变,2例患者有慢性胰腺炎样改变。4例患者胰腺外分泌功能降低,胰液中淀粉酶和/或脂肪酶显著减少。
研究人群中胰腺功能障碍的患病率增至25% - 33%,远高于普通人群。因此,SS患者应考虑胰腺功能障碍和慢性胰腺炎。