自身免疫性胰腺炎对胰腺功能、生活质量和预期寿命的长期影响。
The Long-Term Impact of Autoimmune Pancreatitis on Pancreatic Function, Quality of Life, and Life Expectancy.
作者信息
Buijs Jorie, Cahen Djuna L, van Heerde Marianne J, Rauws Erik A, de Buy Wenniger Lucas J Maillette, Hansen Bettina E, Biermann Katharina, Verheij Joanne, Vleggaar Frank P, Brink Menno A, Beuers Ulrich H W, van Buuren Henk R, Bruno Marco J
机构信息
From the*Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam; †Department of Gastroenterology and Hepatology, Academic Medical Center Amsterdam, Amsterdam; Departments of ‡Public Health and §Pathology, Erasmus University Medical Center, Rotterdam; ∥Department of Pathology, Academic Medical Center Amsterdam, Amsterdam; ¶Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht; and #Department of Gastroenterology, Meander Medical Center, Amersfoort, The Netherlands.
出版信息
Pancreas. 2015 Oct;44(7):1065-71. doi: 10.1097/MPA.0000000000000451.
OBJECTIVE
To evaluate the long-term outcome of autoimmune pancreatitis.
METHODS
Patients with at least 2 years of follow-up were included. Information was collected regarding disease characteristics, treatment outcome, diagnosed malignancies, and mortality. In addition, pancreatic function and quality of life were assessed prospectively.
RESULTS
107 patients were included (87% men, 90% with type 1), with a median follow-up of 74 (interquartile range, 49-108) months. One third was operated for suspected pancreatic cancer (32%). Most patients were (successfully) treated with steroids (83%), but relapses were common (52%), for which no risk factors could be identified. Pancreatic carcinoma was not observed.Prospective data were obtained from 64%, as 17% had died, 7% were lost to follow-up, and 13% refused to participate. After a median of 75 (interquartile range, 50-106) months, 46% still used active treatment. Exocrine and endocrine insufficiencies were highly prevalent (82% and 57%, respectively). Quality of life and survival were not impaired, as compared with a reference population.
CONCLUSIONS
Despite an excellent initial treatment response, relapses are common, even in type 2, and almost half of the patients require maintenance therapy. Pancreatic insufficiency is highly prevalent, which calls for active screening. Pancreatic cancer was not observed, and quality of life and survival are not impaired.
目的
评估自身免疫性胰腺炎的长期预后。
方法
纳入随访至少2年的患者。收集有关疾病特征、治疗结果、确诊的恶性肿瘤和死亡率的信息。此外，前瞻性评估胰腺功能和生活质量。
结果
纳入107例患者（87%为男性，90%为1型），中位随访时间为74（四分位间距，49 - 108）个月。三分之一的患者因疑似胰腺癌接受了手术（32%）。大多数患者（成功地）接受了类固醇治疗（83%），但复发很常见（52%），且未发现复发的危险因素。未观察到胰腺癌。前瞻性数据来自64%的患者，17%的患者死亡，7%失访，13%拒绝参与。中位随访75（四分位间距，50 - 106）个月后，46%的患者仍在接受积极治疗。外分泌和内分泌功能不全非常普遍（分别为82%和57%）。与参照人群相比，生活质量和生存率未受损害。
结论
尽管初始治疗反应良好，但复发很常见，即使在2型患者中也是如此，近一半的患者需要维持治疗。胰腺功能不全非常普遍，需要积极筛查。未观察到胰腺癌，生活质量和生存率未受损害。
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