Romagnuolo Joseph, Talluri Jyothsna, Kennard Elizabeth, Sandhu Bimaljit S, Sherman Stuart, Cote Gregory A, Al-Kaade Samer, Gardner Timothy B, Gelrud Andres, Lewis Michele D, Forsmark Christopher E, Guda Nalini M, Conwell Darwin L, Banks Peter A, Muniraj Thiruvengadam, Wisniewski Stephen R, Tian Ye, Wilcox C Mel, Anderson Michelle A, Brand Randall E, Slivka Adam, Whitcomb David C, Yadav Dhiraj
From the *Digestive Disorders Center, Medical University of South Carolina, Charleston, SC; †Department of Medicine, University of Pittsburgh Medical Center; ‡Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA; §Department of Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA; ∥Department of Medicine, Indiana University School of Medicine, Indianapolis, IN; ¶Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, MO; #Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH; **Department of Medicine, Mayo Clinic, Jacksonville, FL; ††Department of Medicine, University of Florida College of Medicine, Gainesville, FL; ‡‡Department of Medicine, University of Wisconsin School of Medicine, Milwaukee, WI; §§Department of Medicine, Brigham and Women's Hospital, Boston, MA; ∥∥Department of Medicine, Griffin Hospital, Derby, CT; ¶¶Department of Medicine, University of Alabama at Birmingham Hospital, Birmingham, AL; and ##Department of Medicine, University of Michigan School of Medicine, Ann Arbor, MI.
Pancreas. 2016 Aug;45(7):934-40. doi: 10.1097/MPA.0000000000000616.
Historically, chronic pancreatitis (CP) was considered a disease of alcoholic males, but recent data suggest its etiology to be complex. To better understand CP in women, we compared data on women and men with CP in a large, prospectively ascertained multicenter US cohort.
Patients with CP enrolled in the NAPS2 Continuation and Validation study were studied. Information on demographics, etiology, risk factors, phenotype, and treatment(s) used was obtained from detailed questionnaires completed by the patients and physicians.
Of 521 cases, 45% were women. Women were significantly (P < 0.05) less likely to have alcohol etiology (30% vs 58.5%) and more likely to have nonalcoholic etiologies (idiopathic, 32% vs 18%; obstructive, 12% vs 2.4%; genetic, 12.8% vs 7.3%). Demographics, pain experience, morphologic findings, exocrine and endocrine insufficiency, CP-related disability, and use of medical therapies were mostly similar in both sexes. Sphincterotomy (biliary, 33% vs 24%; pancreatic, 38% vs 28%; P < 0.05) was performed more frequently in women, whereas cyst/pseudocyst operations were more common in men (6.6 vs 2.6%, P = 0.02).
Most CP cases in women are from nonalcoholic etiologies. In contrast to many other chronic diseases, clinical phenotype of CP is determined by the disease and is independent of sex.
从历史上看，慢性胰腺炎（CP）被认为是男性酒精性疾病，但最近的数据表明其病因复杂。为了更好地了解女性慢性胰腺炎，我们在美国一个大型前瞻性多中心队列中比较了慢性胰腺炎女性和男性的数据。
对纳入NAPS2延续和验证研究的慢性胰腺炎患者进行研究。通过患者和医生填写的详细问卷获得人口统计学、病因、危险因素、表型和治疗方法等信息。
在521例病例中，45%为女性。女性酒精性病因的可能性显著降低（30%对58.5%），非酒精性病因的可能性更高（特发性，32%对18%；梗阻性，12%对2.4%；遗传性，12.8%对7.3%）。男女在人口统计学、疼痛经历、形态学表现、外分泌和内分泌功能不全、与慢性胰腺炎相关的残疾以及药物治疗的使用方面大多相似。女性括约肌切开术（胆管，33%对24%；胰腺，38%对28%；P<0.05）的实施频率更高，而囊肿/假性囊肿手术在男性中更常见（6.6%对2.6%，P=0.02）。
女性慢性胰腺炎大多由非酒精性病因引起。与许多其他慢性疾病不同，慢性胰腺炎的临床表型由疾病决定，与性别无关。
