Department of Pancreaticobiliar Surgery, Luton & Dunstable NHS Foundation Trust, Lewsey Road, Luton, LU4 0DZ, UK.
Ann Clin Biochem. 2011 Jan;48(Pt 1):23-37. doi: 10.1258/acb.2010.010196. Epub 2010 Oct 6.
Acute pancreatitis (AP) is an important cause of morbidity and mortality worldwide and the annual incidence appears to be increasing. It presents as a mild self-limiting illness in 80% of patients. However, one-fifth of these develop a severe complicated life-threatening disease requiring intensive and prolonged therapeutic intervention. Alcohol and gallstone disease remain the commonest causes of AP but metabolic abnormalities, obesity and genetic susceptibility are thought be increasingly important aetiological factors. The prompt diagnosis of AP and stratification of disease severity is essential in directing rapid delivery of appropriate therapeutic measures. In this review, the range of diagnostic and prognostic assays, severity scoring systems and radiological investigations used in current clinical practice are described, highlighting their strengths and weaknesses. Increased understanding of the complex pathophysiology of AP has generated an array of new potential diagnostic assays and these are discussed. The multidisciplinary approach to management of severe pancreatitis is outlined, including areas of controversy and novel treatments.
急性胰腺炎（AP）是全球范围内发病率和死亡率的重要原因，其发病率似乎在增加。80%的患者表现为轻度自限性疾病。然而，其中五分之一的患者会发展为严重的、威胁生命的复杂疾病，需要强化和长期的治疗干预。酒精和胆石病仍然是 AP 的最常见原因，但代谢异常、肥胖和遗传易感性被认为是越来越重要的病因。快速诊断 AP 和对疾病严重程度进行分层对于指导迅速采取适当的治疗措施至关重要。在这篇综述中，描述了目前临床实践中使用的一系列诊断和预后检测、严重程度评分系统和影像学检查，强调了它们的优缺点。对 AP 复杂病理生理学的认识的提高产生了一系列新的潜在诊断检测方法，对此进行了讨论。概述了严重胰腺炎的多学科管理方法，包括争议领域和新的治疗方法。
