He Yuan-Xiang, Xu Hong-Wei, Sun Xiao-Tian, Ye Zhou, Wang Wei, Lai Xiao-Wei, Wang Xin-Tao, Hu Liang-Hao, Sun Chang, Liao Zhuan, Li Zhao-Shen
From the *Department of Gastroenterology, Changhai Hospital, The Second Military Medical University, Shanghai, China; †Department of Surgical Oncology, General Hospital of Chinese People's Liberation Army, Beijing, China; ‡Department of Gastroenterology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan, China; and §Department of Gastroenterology, Fuzhou General Hospital, Fuzhou, China.
Pancreas. 2014 Aug;43(6):829-33. doi: 10.1097/MPA.0000000000000140.
The aim of this study was to evaluate the M-ANNHEIM classification system to categorize patients with chronic pancreatitis (CP).
All symptomatic patients recruited from the gastroenterology outpatient clinic of Changhai Hospital (n = 89) were routinely evaluated by magnetic resonance cholangiopancreatography and contrast-enhanced computed tomography. M-ANNHEIM clinical staging was used to categorize patients. The primary outcome measure was pain during the 2-year follow-up period, expressed as mean Izbicki pain scores obtained before and after endotherapy.
There was a significant improvement in mean (SD) Izbicki pain scores obtained at 24 months among patients receiving endoscopic therapy at stage 1a compared with those at stage 1b (4.9 [3.0] vs 14.5 [6.9], P = 0.012). Furthermore, significantly more patients receiving endoscopic therapy at stage 1a achieved complete + partial pain relief after 2-year follow-up than those at stage 1b (95.2% vs 78.0%, P = 0.021). There was no exocrine or endocrine insufficiency, but a significantly greater number of patients treated at stage 1a had post-endoscopic retrograde cholangiopancreatography pancreatitis compared with those at stage 1b (10.5% vs 2.7%, P = 0.025).
We demonstrated that a sophisticated M-ANNHEIM classification system for CP will improve diagnosis by allowing for more timely intervention. Furthermore, prompt treatment of CP may achieve improved pain relief and patient outcomes.
本研究旨在评估M-ANNHEIM分类系统对慢性胰腺炎（CP）患者进行分类的情况。
从长海医院胃肠病门诊招募的所有有症状患者（n = 89）均常规接受磁共振胰胆管造影和增强计算机断层扫描评估。采用M-ANNHEIM临床分期对患者进行分类。主要观察指标为2年随访期内的疼痛情况，以内镜治疗前后获得的平均伊兹比基疼痛评分表示。
与1b期患者相比，1a期接受内镜治疗的患者在24个月时获得的平均（标准差）伊兹比基疼痛评分有显著改善（4.9 [3.0] 对14.5 [6.9]，P = 0.012）。此外，1a期接受内镜治疗的患者在2年随访后实现完全 + 部分疼痛缓解的比例显著高于1b期患者（95.2% 对78.0%，P = 0.021）。不存在外分泌或内分泌功能不全，但与1b期患者相比，1a期接受治疗的患者内镜逆行胰胆管造影术后胰腺炎的发生率显著更高（10.5%对2.7%，P = 0.025）。
我们证明，一种完善的CP的M-ANNHEIM分类系统将通过允许更及时的干预来改善诊断。此外，CP的及时治疗可能会实现更好的疼痛缓解和患者预后。
