Fernandez M, Arvanitakis M, Musala C, Devière J, Van Steenbergen W, Putzeys V, Ausloos F, Bastens B, Gast P, Roeyen G, Berrevoet F, Scheers I, Delhaye M, Deprez P H
Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium.
Pancreatology. 2017 Jul-Aug;17(4):572-579. doi: 10.1016/j.pan.2017.05.387. Epub 2017 May 26.
BACKGROUND/OBJECTIVES: The epidemiology, natural history, complications, and therapeutic management of chronic pancreatitis (CP) are not well described at the national level. This multi-centre prospective observational study involving eight Belgian hospitals aimed to improve the understanding of these aspects of CP in Belgium.
All patients with a diagnosis of CP based on imaging were eligible for this study. Data were gathered regarding epidemiology, etiology, CP complications, and treatment modalities.
A total of 809 patients were included between 1/9/2014 and 31/8/2015. Most patients (794) were adults ≥16-years old, 74% were male, the median age at symptom onset was 47 (38-57) years, the median disease duration was 7 (3-13) years, and the median Izbicki pain score (IPS) was 96 (0-195). The main etiological risk factors according to the TIGAR-O classification were alcohol and tobacco (67%). Current drinkers had lower body mass index (BMI) (21.4 kg/m vs 24.1 kg/m), higher IPS (110 vs 56), and longer inability to work than non-drinkers. Current smokers had lower BMI (21.5 kg/m vs 25 kg/m) and higher IPS (120 vs 30) than non-smokers. Endocrine insufficiency and/or clinical steatorrhea was recorded in 41% and 36% of patients, respectively. The highest IPS was reported in patients with ongoing endotherapy (166 vs 50 for patients who completed endoscopy).
This multicentric study on CP patients showed that current alcohol drinking and smoking are associated with pain and malnutrition. Pain scores were higher in patients with ongoing endotherapy, independently of surgery.
背景/目的：在国家层面，慢性胰腺炎（CP）的流行病学、自然病史、并发症及治疗管理情况尚未得到充分描述。这项涉及比利时八家医院的多中心前瞻性观察研究旨在增进对比利时CP这些方面的了解。
所有经影像学诊断为CP的患者均符合本研究条件。收集了有关流行病学、病因、CP并发症及治疗方式的数据。
2014年9月1日至2015年8月31日期间共纳入809例患者。大多数患者（794例）为16岁及以上成年人，74%为男性，症状出现时的中位年龄为47（38 - 57）岁，疾病中位持续时间为7（3 - 13）年，Izbicki疼痛评分（IPS）中位数为96（0 - 195）。根据TIGAR - O分类，主要病因风险因素为酒精和烟草（67%）。与不饮酒者相比，当前饮酒者的体重指数（BMI）较低（21.4kg/m²对24.1kg/m²），IPS较高（110对56），无法工作的时间更长。与不吸烟者相比，当前吸烟者的BMI较低（21.5kg/m²对25kg/m²），IPS较高（120对30）。分别有41%和36%的患者记录有内分泌功能不全和/或临床脂肪泻。正在接受内镜治疗的患者报告的IPS最高（正在接受内镜治疗的患者为166，完成内镜检查的患者为50）。
这项关于CP患者的多中心研究表明，当前饮酒和吸烟与疼痛及营养不良有关。正在接受内镜治疗的患者疼痛评分较高，与手术无关。
