Maev I V, Kucheryavyi Yu A, Andreev D N, Bideeva T V
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia, Moscow, Russia.
Ter Arkh. 2016;88(2):81-89. doi: 10.17116/terarkh201688281-89.
Chronic pancreatitis (CP) is an inflammatory disease of the pancreas, accompanied by damage to the functioning parenchyma and ducts to develop irreversible structural changes (fibrosis, calcification) and irreparable loss of the endocrine and exocrine functions of this organ. Maldigestion is a typical outcome of CP of any etiology with a long-term history. Fat malabsorption is considered as a basis for malnutrition in patients with CP. The severity of malnutrition in patients with CP correlates with three major pathogenetic factors: primary nutrient deficiency, pancreatic maldigestion and secondary malabsorption syndrome (nutrient loss), hypermetabolism that is caused by an inflammatory process in the pancreas and that determines the severity of the disease. Malnutrition in patients with CP is not just a complication of this disease, but has an important impact on its course. Patients with severe malnutrition are noted to have the significantly lower activity of pancreatic enzymes in the duodenal contents, feces, and blood, which is correlated with the smaller blood amount of total protein and albumin.
慢性胰腺炎(CP)是胰腺的一种炎症性疾病,伴有功能性实质和导管受损,进而发展为不可逆的结构改变(纤维化、钙化)以及该器官内分泌和外分泌功能的不可修复性丧失。消化不良是任何病因导致的长期慢性胰腺炎的典型后果。脂肪吸收不良被认为是慢性胰腺炎患者营养不良的基础。慢性胰腺炎患者营养不良的严重程度与三个主要致病因素相关:原发性营养缺乏、胰腺消化功能不良和继发性吸收不良综合征(营养流失)、由胰腺炎症过程引起并决定疾病严重程度的高代谢。慢性胰腺炎患者的营养不良不仅是该疾病的一种并发症,而且对其病程有重要影响。严重营养不良的患者十二指肠内容物、粪便和血液中的胰酶活性显著降低,这与总蛋白和白蛋白的血液含量较低相关。