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慢性胰腺炎的发病率、患病率和生存率:一项基于人群的研究。

Incidence, prevalence, and survival of chronic pancreatitis: a population-based study.

机构信息

Division of Gastroenterology and Hepatology, University of Pittsburgh Medical Center, Pennsylvania 15213, USA.

出版信息

Am J Gastroenterol. 2011 Dec;106(12):2192-9. doi: 10.1038/ajg.2011.328. Epub 2011 Sep 27.

Abstract

OBJECTIVES

Population-based data on chronic pancreatitis (CP) in the United States are scarce. We determined incidence, prevalence, and survival of CP in Olmsted County, MN.

METHODS

Using Mayo Clinic Rochester's Medical Diagnostic Index followed by a detailed chart review, we identified 106 incident CP cases from 1977 to 2006 (89 clinical cases, 17 diagnosed only at autopsy); CP was defined by previously published Mayo Clinic criteria. We calculated age- and sex-adjusted incidence (for each decade) and prevalence rate (1 January 2006) per 100,000 population (adjusted to 2000 US White population). We compared the observed survival rate for patients with expected survival for age- and sex-matched Minnesota White population.

RESULTS

Median age at diagnosis of CP was 58 years, 56% were male, and 51% had alcoholic CP. The overall (clinical cases or diagnosed only at autopsy) age- and sex-adjusted incidence was 4.05/100,000 person-years (95% confidence interval (CI) 3.27-4.83). The incidence rate for clinical cases increased significantly from 2.94/100,000 during 1977-1986 to 4.35/100,000 person-years during 1997-2006 (P<0.05) because of an increase in the incidence of alcoholic CP. There were 51 prevalent CP cases on 1 January 2006 (57% male, 53% alcoholic). The age- and sex-adjusted prevalence rate per 100,000 population was 41.76 (95% CI 30.21-53.32). At last follow-up, 50 patients were alive. Survival among CP patients was significantly lower than age- and sex-specific expected survival in Minnesota White population (P<0.001).

CONCLUSIONS

Incidence and prevalence of CP are low, and ∼50% are alcohol related. The incidence of CP cases diagnosed during life is increasing. Survival of CP patients is lower than in the Minnesota White population.

摘要

目的

美国有关慢性胰腺炎(CP)的人群数据较为匮乏。我们旨在明尼苏达州奥姆斯特德县(Olmsted County,MN)CP 的发病、患病和生存情况。

方法

通过 Mayo 诊所罗切斯特的医学诊断索引(Medical Diagnostic Index),结合详细的图表审查,我们从 1977 年至 2006 年共发现了 106 例新发病例(89 例临床病例,17 例仅尸检确诊);CP 的定义采用之前公布的 Mayo 诊所标准。我们计算了每 100000 人口(调整至 2000 年美国白人人口)中每 10 年的年龄和性别调整发病率(incidence)以及患病率(rate)(截至 2006 年 1 月 1 日)。我们比较了患者的实际生存率与年龄和性别相匹配的明尼苏达州白人人口的预期生存率。

结果

CP 的中位诊断年龄为 58 岁,56%为男性,51%为酒精性 CP。总体(临床病例或仅尸检确诊)年龄和性别调整发病率为 4.05/100000 人年(95%置信区间(CI)3.27-4.83)。1977-1986 年临床病例的发病率为 2.94/100000,1997-2006 年增加至 4.35/100000 人年(P<0.05),主要原因是酒精性 CP 的发病率增加。2006 年 1 月 1 日有 51 例现患 CP(57%为男性,53%为酒精性)。调整年龄和性别后,每 100000 人年的患病率为 41.76(95%CI 30.21-53.32)。末次随访时,50 例患者存活。CP 患者的生存率明显低于明尼苏达州白人人口的特定年龄和性别预期生存率(P<0.001)。

结论

CP 的发病率和患病率较低,约 50%与酒精有关。诊断为活存 CP 病例的发病率在不断增加。CP 患者的生存率低于明尼苏达州白人人口。

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