Rajesh Gopalakrishna, Veena Ambadiyil Balan, Menon Saumya, Balakrishnan Vallath
Amrita Institute of Medical Sciences, Kochi, AIMS Ponekkara P.O., 682 041, Kochi, India.
Indian J Gastroenterol. 2014 May;33(3):231-6. doi: 10.1007/s12664-013-0421-3. Epub 2013 Nov 14.
Idiopathic chronic pancreatitis (ICP) is the most common form of chronic pancreatitis reported in India. There is paucity of literature on the prevalence and profiles of early- and late-onset forms of ICP in India.
We compared the profile of early- and late-onset ICP in a patient population attending a tertiary care hospital in South India.
Pain was the characteristic feature as more than 90 % with both early-onset and late-onset ICP had pain as the most significant symptom. Onset of pain was at age 14.9 ± 7.7 years in early-onset and at 38.1 ± 9.9 in late-onset ICP (p < 0.001). There was considerable delay between onset of pain in early onset as compared to late-onset ICP. Diabetes was seen in 41.4 % in early-onset as compared to 69.1 % in late-onset ICP (p < 0.001). Pancreatic exocrine insufficiency was seen in 34.4 % in early-onset as compared to 53.2 % in late-onset ICP (p < 0.001). Increased prevalence of exocrine insufficiency and diabetes was observed in late-onset as compared to early-onset ICP. Univariate analysis showed that alcohol use, smoking, age, and family history of diabetes were significantly associated with diabetes. Multivariate analysis showed strong associations for diabetes with smoking (odds ratio (OR) = 4.2), calcification (OR = 7.7), as well as family history and age >40 years.
There were differences between early-onset and late-onset ICP in southern Indian patients. Diabetes was strongly associated with smoking and pancreatic calcification.
特发性慢性胰腺炎（ICP）是印度报道的最常见的慢性胰腺炎形式。关于印度早发型和晚发型ICP的患病率及特征的文献较少。
我们比较了在印度南部一家三级护理医院就诊的患者群体中早发型和晚发型ICP的特征。
疼痛是其特征性表现，早发型和晚发型ICP中均有超过90%的患者以疼痛为最主要症状。早发型ICP疼痛发作年龄为14.9±7.7岁，晚发型为38.1±9.9岁（p<0.001）。与晚发型ICP相比，早发型ICP疼痛发作后有相当长的延迟。早发型ICP患者中糖尿病发生率为41.4%，晚发型为69.1%（p<0.001）。早发型ICP患者中胰腺外分泌功能不全发生率为34.4%，晚发型为53.2%（p<0.001）。与早发型ICP相比，晚发型ICP中外分泌功能不全和糖尿病的患病率更高。单因素分析显示，饮酒、吸烟、年龄和糖尿病家族史与糖尿病显著相关。多因素分析显示，糖尿病与吸烟（比值比（OR）=4.2）、钙化（OR=7.7）以及家族史和年龄>40岁密切相关。
印度南部患者的早发型和晚发型ICP存在差异。糖尿病与吸烟和胰腺钙化密切相关。
